经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症的效果观察

Efficacy of transforaminal percutaneous endoscopic resection of submedullary nucleus in the treatment of lumbar disc herniation

目的探究经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症的效果。方法选取大同市第三人民医院2018年5月至2019年7月收治的腰椎间盘突出症患者78例为研究对象,依据手术方法将纳入患者分为对照组与观察组。其中对照组(n=39)行椎板开窗减压髓核摘除术治疗,观察组(n=39)行经皮椎间孔镜下髓核摘除术治疗。观察两组患者的治疗效果、手术指标、并发症发生情况、治疗前后Oswedtry功能障碍指数评分(ODI)及视觉模拟评分(VAS)。结果观察组总有效率(94.87%,37/39)高于对照组(71.79%,28/39),差异有统计学意义(χ^2=7.477,P<0.05)。观察组术中出血量[(38.35±17.64)ml]、住院时间[(5.16±0.49)d]、手术时间[(72.32±28.62)min]均低于对照组[(90.3±35.68)ml、(12.63±3.56)d、(120.13±37.41)min],P均<0.05。术后6个月,观察组VAS评分[(0.99±0.11)分]、ODI评分[(4.38±0.96)分]低于对照组[(2.87±0.68)、(9.87±2.40)分],P<0.05。观察组的并发症总发生率为5.13%(2/39),低于对照组的28.21%(11/39),差异有统计学意义(χ^2=7.477,P<0.05)。结论采用经皮椎间孔镜下髓核摘除术可有效治疗腰椎间盘突出症,减少术中出血量,缩短住院时间,降低并发症发生率,缓解疼痛程度,促进患者功能障碍恢复。

Objective To investigate the therapeutic effects of transforaminal percutaneous endoscopic resection of submedullary nucleus on of lumbar disc herniation.Methods Seventy-eight patients with lumbar disc herniation treated in the Third People’s Hospital of Datong from May 2018 to July 2019 were selected as research objects.According to surgical methods,the selected patients were divided into control group and observation group.Patients in the control group(n=39)underwent conical plate open decompression nucleus myeldectomy,and patients in the observation group(n=39)underwent transforaminal percutaneous endoscopic resection of submedullary nucleus.The treatment effects,surgical indexes,incidence of complications,Oswedtry Dysfunction Index(ODI)score and Visual Analogue Scale(VAS)score of the two groups were observed.Results The total effective rate of the observation group was 94.87%(37/39),significantly higher than the 71.79%(28/39)of the control group(χ^2=7.477,P<0.05).In the observation group,the intraoperative bleeding volume,hospitalization time and operation time were(38.35±17.64)ml,(5.16±0.49)d and(72.32±28.62)min respectively,significantly lower than the(90.3±35.68)ml,(12.63±3.56)d and(120.13±37.41)min in the control group(all P<0.05).The VAS and ODI scores 6 months after treatment in the observation group were 0.99±0.11 and 4.38±0.96 respectively,significantly lower than the 2.87±0.68 and 9.87±2.40 in the control group(P<0.05).The total incidence of complications in the observation group was 5.13%(2/39),significantly lower than the 28.21%(11/39)in the control group(χ^2=7.477,P<0.05).Conclusions Using transforaminal percutaneous endoscope to remove nucleus pulposus can effectively treat lumbar disc herniation,significantly reduce intraoperative bleeding,shorten hospital stay,reduce the incidence of complications,relieve the degree of pain,and promote the recovery of dysfunction.