微创手术治疗腰椎间盘突出症疼痛的临床作用及患者满意度探讨

The Clinical Effect of Minimally Invasive Surgery on the Pain of Lumbar Intervertebral Disc Herniation and Patient Satisfaction

目的分析微创手术治疗腰椎间盘突出症疼痛的临床作用及患者满意度。方法在该院2018年3月—2019年7月接受治疗的腰椎间盘突出症疼痛患者中方便抽选58例作为研究对象。用数字随机分组的方式将患者分为两组,对照组患者均接受微创腰椎椎间固定融合术(MIS-TLIF)治疗,观察组患者给予皮椎间孔镜腰椎间盘切除术(PELD)治疗,比较两组患者的手术指标、疼痛症状和功能改善情况,统计两组患者的手术效果满意度情况。结果观察组患者的手术耗时(85.71±6.84)min、住院时间(7.26±0.59)d均明显短于对照组,其住院费用(15359.64±100.77)元明显少于对照组,差异有统计学意义(t=24.729、27.969、272.109,P<0.05);观察组患者术后2周腰痛VAS评分(1.62±0.07)分和术后3 d腿痛VAS评分(1.68±0.07)分均明显低于对照组,差异有统计学意义(t=52.687、36.600,P<0.05);两组患者术后1、3、6、12个月的腰痛、腿痛VAS评分相比,差异无统计学意义(P>0.05);两组患者术后ODI评分以及手术效果满意度评分相比较,差异无统计学意义(P>0.05)。结论PELD和MIS-TLIF治疗腰椎间盘突出症疼痛的疗效可观,其中PELD的近期疗效更为显著。

Objective To analyze the clinical effects and patient satisfaction of minimally invasive surgery for the pain of lumbar disc herniation.Methods 58 patients with lumbar disc herniation and pain who were treated in the hospital from March 2018 and July 2019 were convenient selected as the observation objects in this article.The patients were divided into two groups by number randomization.Patients in the control group were treated with minimally invasive lumbar interbody fixation and fusion(MIS-TLIF),and patients in the observation group were treated with skin foraminal lumbar discectomy(PELD),compare the surgical indicators,pain symptoms and functional improvement of the two groups of patients,and calculate the satisfaction with the surgical results of the two groups.Results The operation time of the observation group was(85.71±6.84)min,and the hospitalization time(7.26±0.59)d was significantly shorter than that of the control group.The hospitalization cost was(15359.64±100.77)yuan,which was significantly less than that of the control group,the difference was statistically significant(t=24.729,27.969,272.109,P<0.05);the observation group's low back pain VAS score(1.62±0.07)points after 2 weeks postoperatively and the leg pain VAS score(1.68±0.07)points after 3 d postoperatively were significantly lower than those of the control group,the difference was statistically significant(t=52.687,36.600,P<0.05);compared with the VAS scores of low back pain and leg pain in the two groups at 1 month,3 months,6 months and 12 months after surgery,the difference was not statistically significant(P>0.05);Comparison of postoperative ODI score and surgical effect satisfaction score between the two groups,the difference was not statistically significant(P>0.05).Conclusion PELD and MIS-TLIF are effective in treating the pain of lumbar intervertebral disc herniation,and the short-term effect of PELD is more significant.