地塞米松明胶海绵在腰椎间盘突出症髓核摘除术后的应用

Application of dexamethasone gelatin sponge in the treatment of lumbar disc herniation after nucleus pulposus extraction

目的探讨地塞米松明胶海绵在腰椎间盘突出症髓核摘除术后的应用效果,为患者的临床诊疗提供参考依据。方法选取2018年1月至2019年5月在西安交通大学附属红会医院就诊的腰椎间盘突出症髓核摘除术后患者92例进行研究。按随机数表法将患者均分为观察组和对照组各46例。对照组患者给予生理盐水复合胶原海绵治疗,观察组患者给予地塞米松明胶海绵治疗。治疗4周后观察两组患者的治疗效果,比较患者治疗前及治疗后48 h的疼痛等级评定量表(VAS)评分及功能障碍指数问卷表(ODI)评分,以及并发症发生情况。结果治疗4周后,观察组患者的治疗总有效率为95.65%,明显高于对照组的73.91%,差异有统计学意义(P<0.05);治疗前,两组患者的VAS评分和ODI评分比较差异均无统计学意义(P>0.05);治疗后48 h,两组患者的VAS评分和ODI评分均明显降低,且观察组VAS评分、ODI评分明显低于对照组,差异均有统计学意义(P<0.05);治疗后,观察组患者的并发症总发生率为2.17%,明显低于对照组的17.39%,差异有统计学意义(P<0.05)。结论腰椎间盘突出症髓核摘除术后应用地塞米松明胶海绵治疗能有效缓解患者术后神经根疼痛,减少并发症的发生,临床治疗效果显著。

Objective To investigate the effect of dexamethasone gelatin sponge in the treatment of lumbar disc herniation after nucleus pulposus extraction,and to provide reference for clinical diagnosis and treatment.Methods Ninety-two patients with lumbar intervertebral disc herniation after nucleus pulposus resection were selected from Xi’an Honghui Hospital from January 2018 to May 2019.According to the random number method,the patients were divided into observation group and control group,with 46 patients in each group.The control group was treated with normal saline combined with collagen sponge,and the observation group was treated with dexamethasone gelatin sponge.After 4 weeks of treatment,the treatment effect of the two groups of patients was observed,and Visual Analogue Scale(VAS)score and dysfunction index questionnaire(ODI)score of patients before and 48 hours after treatment were compared.The incidence of complications was also compared.Results After 4 weeks of treatment,the total effective rate of treatment in the observation group patients was 95.65%,which was significantly higher than 73.91%in the control group(P<0.05).Before treatment,the VAS and ODI scores of the two groups showed no statistically significant difference(P>0.05);48 h after treatment,the VAS and ODI scores of the two groups were significantly reduced,and the VAS score and ODI score of the observation group were significantly lower than those of the control group(P<0.05).After treatment,the incidence of complications in the observation group was 2.17%,which was significantly lower than 17.39%in the control group(P<0.05).Conclusion Dexamethasone gelatin sponge can effectively relieve postoperative nerve root pain in patients with lumbar intervertebral disc herniation after nucleus pulposus extraction,reduce the incidence of complications,promote the patient’s recovery process,with remarkable clinical effect.