经皮椎间孔镜椎间盘切除术治疗腰椎间盘突出症患者的可行性

Feasibility of percutaneous transforaminal endoscopic discectomy in treatment of patients with lumbar disc herniation

目的研究探讨经皮椎间孔镜椎间盘切除术(PTED)与椎板开窗术治疗腰椎间盘突出症的临床效果。方法选取我院2016年1月~2018年6月收治的360例腰椎间盘突出症的患者,随机分为观察组与对照组,其中观察组220例患者接受经皮椎间孔镜椎间盘切除术,对照组140例患者接受传统的椎板开窗术治疗,治疗结束后,比较两组患者的临床治疗效果,观察并记录两组患者术前以及术后的视觉疼痛模拟评分(VAS),两组患者术后6个月的生活质量核心量表(QOL-C30)评分。结果观察组的手术时间、切口长度以及住院时间等围手术期效果均明显优于对照组患者,观察组患者术后视觉疼痛模拟评分以及术后6个月的生活核心量表评分均显著优于对照组患者,差异均有统计学意义(P<0.05)。两组患者术前视觉疼痛模拟评分比较差异无统计学意义(P>0.05)。结论经皮椎间孔镜椎间盘切除术与传统椎板开窗术均可以治疗腰椎间盘突出症,但经皮椎间孔镜椎间盘切除术的围手术期的治疗效果更佳,创伤小,患者术后疼痛较小,可明显提高患者术后的生活质量,值得临床推广应用。

Objective To study and explore clinical curative effects of percutaneous transforaminal endoscopic discectomy(PTED)and vertebral lamina fenestration in treatment of patients with lumbar disc herniation.Methods 360 patients with lumbar disc herniation who were admitted and treated in our hospital from January 2016 to June 2018 were selected.They were randomly divided into the observation group and the control group.220 patients in the observation group underwent percutaneous transforaminal endoscopic discectomy while 140 patients in the control group were treated with traditional vertebral lamina fenestration.After treatment,clinical curative effects of patients of the two groups were compared.The visual pain simulation scores(VAS)before and after surgery and quality of life core scale(QOL-C30)scores of 6 months after surgery in two groups were observed and recorded.Results The perioperative effects such as operation time,length of incision and hospital stay of the observation group were significantly better than those of the control group.The postoperative visual pain simulation score and quality of life core scale score of 6 months after surgery in the observation group were significantly better than those in the control group.The differences were statistically significant(P<0.05).There was no statistically significant difference in the preoperative visual pain simulation scores between the two groups(P>0.05).Conclusion Percutaneous transforaminal endoscopic discectomy and vertebral lamina fenestration both can treat lumbar disc herniation while perioperative curative effects of percutaneous transforaminal endoscopic discectomy are better.The trauma is small and the postoperative pain is less,which can significantly improve the quality of life of patients after surgery.It is worthy of clinical promotion and application.