经皮椎间孔镜法治疗腰椎间盘突出症的效果观察

Observation of the Effect of Percutaneous Transforaminal Endoscopic Discectomy for the Treatment of Lumbar Disc Herniation

目的:探究经皮椎间孔镜法治疗腰椎间盘突出症的效果。方法:选择我院于2018年1月2020年3月收治的腰椎间盘突出症患者77例为研究对象,根据入院顺序经随机数字表法分成两组,给予对照组39例患者进行开放手术:腰椎后路间盘切除、椎间融合、椎弓根钉内固定术,给予研究组38例患者经皮椎间孔镜法进行治疗。对比两组治疗后腰部功能恢复情况;两组手术时间、术中出血量、住院天数、切口长度等临床指标;两组术前及术后1 d白介素-1β(Inter leukin-1β,IL-1β)及C反应蛋白(C-reactive protein,CRP)水平。结果:研究组的腰部功能恢复总优良率92.11%(35/38)显著高于对照组的腰部功能恢复总优良率66.67%(26/39)(P<0.05);研究组的术中出血量、住院天数、切口长度、手术时间均显著少(短)于对照组(P<0.05);术前,两组的IL-1β、CRP水平对比无显著性差异(P>0.05);术后1 d,两组的IL-1β、CRP水平均比术前显著升高,但研究组显著低于对照组(P<0.05)。结论:经皮椎间孔镜法治疗腰椎间盘突出症的效果显著,可有效改善患者临床指标,且损伤较小,值得推荐至临床广泛应用。

Objective:To explore the effect of percutaneous transforaminal endoscopic discectomy for the treatment of lumbar disc herniation.Methods:77 patients with lumbar disc herniation treated in our hospital from January 2018 to March 2020 were selected as the research subjects.They were divided into two groups by random number table according to the order of admission.39 patients in the control group were given open surgery:posterior lumbar discectomy,intervertebral fusion,pedicle screw internal fixation,and 38 patients in the study group were treated with percutaneous endoscopic.Compare the recovery of lumbar function after treatment between two groups of patients.Comparison of clinical indicators such as surgical time,intraoperative blood loss,length of hospital stay,and incision length between the two groups of patients.The levels of interleukin-1β(IL-1β)and C-reactive protein(CRP)were compared between the two groups of patients before and 1 day after surgery.Results:The total excellent rate of waist function recovery in the study group was 92.11%(35/38),which was significantly higher than that of the control group.The total excellent rate of waist function recovery was 66.67%(26/39)(P<0.05).Intraoperative blood loss,length of hospital stay,length of incision,and operation time were significantly less(shorter)in the study group than in the control group(P<0.05).Before surgery,there was no significant difference in the levels of IL-1βand CRP between the two groups of patients(P>0.05).One day after surgery,the levels of IL-1βand CRP in the two groups were significantly higher than before surgery,but the study group was significantly lower than the control group(P<0.05).Conclusion:Percutaneous intervertebral foramen is effective in treating lumbar intervertebral disc herniation.This method can effectively improve the clinical indicators of patients,and has less damage to patients.It is recommended to be widely used in clinical practice.