跪式体位和常规体位下手术治疗腰椎间盘突出症效果比较

Comparison of the Effect of Kneeling Position and Routine Postures in the Treatment of Lumbar Disc Herniation

目的本研究将跪式体位与常规的俯卧位下行髓核摘除术进行对比,集中探究两种体位的手术治疗效果的差异。方法选取2019年6月—2022年6月盐城市第一人民医院收治的200例腰椎间盘突出症患者作为研究对象,并分为跪式体位组和常规体位组,每组各100例。其中跪式体位组采取跪式体位进行手术治疗,常规体位组采取俯卧位进行手术治疗。依次对比两组患者的围手术期指标、腰椎功能恢复情况、临床有效率以及不良反应发生率。结果跪式体位组的手术时长、术中出血量、绝对卧床时长及住院时长均短于常规体位组;手术后1周,两组患者的功能障碍指数(oswestry disability index,ODI)及日本骨科协会评估治疗分数(Japanese Orthopaedic Association Scores,JOA)评分较手术前均有改善,其中跪式体位组的改善程度高于常规体位组;跪式体位组的临床有效率高于常规体位组,而不良反应发生率低于常规体位组,差异均有统计学意义(P<0.05)。结论在对腰椎间盘突出症的患者进行手术治疗时采取跪式体位,能够通过扩大操作者视野、充分暴露病灶部位,达到充分清除突出物的压迫、减少术中损伤及有效促进患者腰椎功能恢复的目的。

Objective To compare the kneeling posture and the conventional prone posture for downward nucleus pulposus removal,and focus on exploring the difference of surgical treatment effect between the two positions.Methods A total of 200 patients with lumbar disc herniation admitted to the Yancheng NO.1 People's Hospital from June 2019 to June 2022 were included as the research objects and divided into kneeling posture group and conventional posture group,with 100 patients in each group.The kneeling posture group was operated in kneeling posture,while the conventional posture group was operated in prone posture.The perioperative indexes,recovery of lumbar function,clinical effective rate and adverse reaction rate of the two groups were compared in turn.Results The operation time,intraoperative blood loss,absolute bed rest time and hospitalization time in the kneeling posture group were shorter than those in the conventional posture group.One week after the operation,the scores of the oswestry disability index(ODI)and the Japanese Orthopaedic Association Scores(JOA)of the patients in both groups were improved compared with those before the operation,and the improvement degree of the kneeling posture group was higher than that of the conventional posture group.The clinical effective rate of the kneeling posture group was higher than that of the conventional posture group,while the incidence of adverse reactions was lower than that of the conventional posture group.The differences were statistically significant(P<0.05).Conclusion The kneeling posture adopted in the surgical treatment of patients with lumbar disc herniation can fully eliminate the compression of protrusions,reduce intraoperative injuries and effectively promote the recovery of patients'lumbar function by expanding the operator's vision and fully exposing the focus.