经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症的临床疗效分析

Clinical Efficacy Analysis of Percutaneous Transforaminal Endoscopic Discectomy in Treatment of Lumbar Disc Herniation

目的:探讨经皮椎间孔镜髓核摘除术(PTED)治疗腰椎间盘突出症(LDP)的临床疗效。方法:选取2018年3月-2021年7月江苏省人民医院溧阳分院收治的LDP患者100例为观察对象,根据手术方案不同分为对照组与观察组,各50例。对照组接受小切口椎板间开窗髓核摘除术,观察组接受PTED治疗。比较两组患者手术前后腰椎功能、创伤反应、并发症发生率。结果:术后,两组患者Oswestry功能障碍指数(ODI)评分均降低,日本骨科协会(JOA)评分均升高,观察组ODI评分低于对照组,JOA评分高于对照组,差异有统计学意义(P<0.05)。术后,两组患者C反应蛋白、皮质醇、前列腺素E2水平均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组患者并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:PTED可促进LDP患者腰椎功能恢复,减轻手术创伤反应,减少并发症发生率。

Objective:To investigate the clinical efficacy of percutaneous transforaminal endoscopic discectomy(PTED)in treatment of lumbar disc herniation(LDP).Methods:A total of 100 patients with LDP who were treated in Liyang Branch of Jiangsu Province Hospital from March 2018 to July 2021 were selected as the observation objects.They were divided into the control group and the observation group according to different surgical plans,with 50 cases in each group.The control group received small incision interlaminar fenestration for nucleus pulposus removal,and the observation group received PTED treatment.The lumbar spine function,trauma response,and complication rates before and after surgery were compared between the two groups.Results:After surgery,the Oswestry Disability Index(ODI)score was decreased and the Japanese Orthopaedic Association(JOA)score was increased in the two groups,the ODI score of the observation group was lower than that of the control group,and the JOA score was higher than that of the control group,with statistically significant difference(P<0.05);after surgery,the levels of C-reactive protein,cortisol and prostaglandin E2 were decreased in the two groups,and the observation group was lower than the control group,with statistically significant difference(P<0.05).The incidence of complications in the observation group was lower than that in the control group,with statistically significant difference(P<0.05).Conclusion:PTED can promote the recovery of lumbar spine function in patients with LDP,reduce surgical trauma response,and reduce the incidence of complications.