经皮椎间孔镜技术在腰椎间盘突出症患者中的应用效果研究

Study on the application of percutaneous endoscopic lumbar discectomy in patients with lumbar disc herniation

目的探讨分析经皮椎间孔镜技术在腰椎间盘突出症患者中的应用效果。方法选取2020年3月至2021年2月在临沂市中医医院治疗的腰椎间盘突出症患者88例进行研究,依据随机数字表法分为对照组45例,试验组43例。对照组患者采用传统手术治疗,试验组患者实施经皮椎间孔镜技术进行治疗。观察比较两组患者治疗前及治疗后1个月的炎症因子水平,两组患者治疗前及治疗后6个月的JOA,ODI以及VAS评分情况。结果术前,两组间的TNF-α,IL-1以及IL-6水平比较,差异无统计学意义(P>0.05);术后,两组患者TNF-α,IL-1以及IL-6水平均下降,均低于术前水平,组内比较差异均有统计学意义(P<0.05);且试验组患者术后TNF-α,IL-1以及IL-6水平均低于对照组,差异有统计学意义(P<0.05)。术前,两组患者的JOA、ODI以及VAS评分比较,差异均无统计学意义(P>0.05);术后,两组患者的JOA、ODI以及VAS评分均有改善,且组内比较差异均有统计学意义(P<0.05),术后试验组的JOA评分高于对照组,ODI以及VAS评分均低于对照组,组间比较差异均有统计学意义(P<0.05)。结论对于腰椎间盘突出症患者实施经皮椎间孔镜技术治疗效果较好,可以有效降低机体炎症反应,改善功能障碍以及缓解疼痛。

Objective To investigate and analyze the effect of percutaneous endoscopic lumbar discectomy(PELD)in patients with lumbar disc herniation.Methods A total of 88 patients with lumbar disc herniation treated in Linyi Traditional Chinese Medicine Hospital from March 2020 to February 2021 were selected and divided into groups according to the random number table,including 45 patients in the control group and 43 patients in the experimental group.The patients in the control group were treated with traditional surgery and the patients in the experimental group underwent PELD.The inflammatory factors before and 1 month after treatment,Japanese Orthopaedic Association score(JOA),Oswestry Disability Index(ODI)and Visual Analog Scale(VAS)scores before and 6 months after treatment were observed and compared between the two groups.Results Before the operation,there were no statistically significant differences in the levels of Tumor Necrosis Factor-α(TNF-α),interleukin-1(IL-1)and interleukin-6(IL-6)between the two groups(P>0.05).After the operation,TNF-α,IL-1 and IL-6 in both groups decreased,which were lower than the preoperative levels and there were statistically significant differences before and after the operation within the group(P<0.05).The postoperative levels of TNF-α,IL-1 and IL-6 in the patients of the experimental group were significantly lower than those in the control group,with statistically significant differences(P<0.05).Before the operation,there were no statistically significant differences in JOA,ODI and VAS scores between the two groups(P>0.05).After the operation,the JOA,ODI and VAS scores of the two groups increased,and there were statistically significant differences before and after the operation within the group(P<0.05).The JOA score of the experimental group was higher than that of the control group,the ODI and VAS scores were lower than those of the control group and the differences between the groups were statistically significant(P<0.05).Conclusion PELD is effective in the treatment of patients with lumbar disc herniation,which can effectively reduce the inflammatory response,improve dysfunction and relieve pain.