经皮内镜椎间盘切除术与传统开窗椎间盘切除术的疗效比较

Efficacy of Two Surgical Treatment of Lumbar Disc Herniation:Percutaneous Endoscopic Interlaminar Discectomy and Open Fenestration Discectomy

目的:比较经皮内镜椎间盘切除术(Percutaneous Endoscopic Interlaminar Discectomy,PEID)和开窗椎间盘切除术(Open Fenestration Discectomy,OFD)治疗单阶段腰椎间盘突出症(Lumbar Disc Herniation,LDH)的临床疗效及预后。方法:回顾性分析2020年5月-2021年5月收治的77例单阶段腰椎间盘突出症患者的临床资料,随机分为观察组和对照组,观察组给予经皮内镜椎间盘切除术,对照组给予开窗椎间盘切除术,比较两组患者临床疗效及复发情况。结果:观察组手术时间、术后恢复正常活动时间、住院时间显著短于对照组相应指标(P<0.05);观察组术中出血量少于对照组相应指标(P<0.05);观察组住院费用高于对照组差异有统计学意义(P<0.05);术后复发率观察组低于对照组,差异无统计学意义(P>0.05)。结论:两种术式均能够安全有效地治疗腰椎间盘突出症患者。相比而言,PEID术具有手术时间短、创伤小、术后恢复快等优点,然而,却存在费用较高的劣势。因此,应遵循个体化的标准,根据患者具体情况来决定手术方式。

Objective:To compare clinical effect of lumbar disc herniation between percutaneous endoscopic interlaminar discectomy and open fenestration discectomy in the treatment of single-level lumbar disc herniation(LDH).Methods:77 cases of single-level lumbar disc herniation patients who accepted reatments in our hospital during May 2020 and May 2021 were selected.They were divided into the observation group and the control group randomly.The observation group patients were given percutaneous endoscopic interlaminar discectomy fortreatment,while the control group patients were treated with open fenestration discectomy.Then we compare the clinical efficacy and complications between the two groups of patients.Results:The operation time,time to resume normal activities after surgery and hospitalization time in the observation group were significantly shorter than that of the control group(P<0.05);The amount of bleeding in the observation group was significantly less than that of the control group(P<0.05);The hospitalization expenses in the observation group was more expensive than that of the control group(P<0.05).The recurrence rate in the observation group was lower than that of the control group(P>0.05).Conclusions:Two types of surgery can both cure the lumbar disc herniation patients safely and effectively.But they both have advantages and disadvantages.Percutaneous endoscopic interlaminar discectomy has the advantages of short operation time,small injuries and fast recovery.However,it has the disadvantages of expense cost and difficult operation.Therefore,we should obey the individualized standard and choose the operation methods by the specific situation of patients.