经皮椎间孔镜下髓核切除术对腰椎间盘突出症患者腰椎功能与炎性因子的影响

Effects of Percutaneous Transforaminal Nucleus Pulposus Removal on Lumbar Function and Inflammatory Factors in Patients with Lumbar Disc Herniation

目的探究经皮椎间孔镜下髓核切除术对腰椎间盘突出症患者腰椎功能与炎性因子的影响。方法选取2019年10月至2020年6月盐亭县人民医院收治的98例腰椎间盘突出症患者,按照随机数字表法分成对照组(49例)和观察组(49例)。对照组患者接受小切口椎板间开窗髓核摘除术,观察组患者接受经皮椎间孔镜下髓核切除术,两组患者均术后随访2个月。比较两组患者术后2个月临床疗效、围术期相关指标,术前与术后2个月腰椎功能,术前与术后3 d血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、超敏-C反应蛋白(hs-CRP)水平。结果术后2个月观察组患者临床优良率为89.79%,与对照组的79.55%比,差异无统计学意义(P>0.05);观察组患者住院时间、手术时间、切口长度均显著短于对照组,术中出血量显著少于对照组;与术前比,术后2个月两组患者日本骨科协会评估治疗分数(JOA)评分均升高,观察组显著高于对照组;两组患者Oswestry功能障碍指数(ODI)评分均下降,观察组显著低于对照组;与术前比,术后3 d两组患者血清TNF-α、IL-6、hs-CRP水平均升高,但观察组显著低于对照组(均P<0.05)。结论经皮椎间孔镜下髓核切除术可有效改善腰椎间盘突出症患者围术期指标与腰椎功能,抑制炎症进程。

Objective To explore the effects of Percutaneous transforaminal nucleus pulposus removal on lumbar function and inflammatory factors in patients with lumbar disc herniation.Methods A total of 98 patients with lumbar disc herniation who were admitted to Yanting County People's Hospital from October 2019 to June 2020 were selected and divided into control group(49 cases)and observation group(49 cases)according to the random number table method.Patients in the control group underwent small incision interlaminar fenucleation of nucleus pulposus,and patients in the observation group underwent percutaneous transforaminal nucleus pulposus removal.Patients in both groups were followed up for 2 months.The clinical efficacy 2 months after operation and perioperative indicators,lumbar function before and 2 months after operation and serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),hypersensitive-C reactive protein(hs-CRP)levels before and 3 days after operation were compared between the two groups.Results The clinical total effective rate of the observation group 2 months after operation was 89.79%,which was not significantly different from 79.55%of the control group(P>0.05);the hospitalization time,operation time and incision length of the observation group were significantly shorter than those of the control group,and the intraoperative blood loss was significantly less than that of the control group;compared with before operation,the Japanese Orthopaedic Association(JOA)scores of the two groups increased 2 months after operation,the observation group was significantly higher than the control group;the Oswestry Dysfunction Index(ODI)scores of the two groups of patients decreased,and the observation group was significantly lower than the control group;compared with preoperatively,the levels of serum TNF-α,IL-6 and hs-CRP in the two groups increased 3 days after operation,but the observation group was significantly lower than the control group(all P<0.05).Conclusion Percutaneous transforaminal nucleus pulposus removal can effectively improve the perioperative indicators and lumbar function of patients with lumbar disc herniation,and inhibit the inflammation process.