经皮椎间孔镜辅助椎间盘切除术治疗腰椎间盘突出症的疗效

CURATIVE EFFECT OF TREATMENT OF LUMBAR DISC HERNIATION WAS TREATED BY IMPROVED CUTANEOUS INTERVERTEBRAL DISC RESECTION

目的探讨经皮椎间孔镜辅助椎间盘切除术治疗腰椎间盘突出症的疗效。方法回顾分析2018年6月—2021年6月唐山市人民医院收治的68例腰椎间盘突出症患者,按照手术方式的不同分为对照组32例和观察组36例。对照组行传统椎板开窗髓核切除术进行治疗,观察组行经皮椎间孔镜辅助下椎间盘切除术。比较二组患者术中术后相关指标(切口长度、出血量、住院手术时间、下地时间),比较二组术前及术后6个月视觉模拟评分量表(VAS)、功能障碍指数评分(ODI),比较二组手术并发症(感染、便秘、尿潴留、痛觉过敏)情况,手术治疗效果情况(6个月后)。结果观察组术中术后相关指标明显短于或少于对照组术中相关指标,差异均有统计学意义(P<0.05);治疗6个月后观察组VAS评分及ODI评分明显低于对照组,差异均具有统计学意义(P<0.05);治疗后观察组出血感染、便秘、尿潴留、痛觉过敏的并发症发生率低于对照组,差异有统计学意义(P<0.05);经治疗后观察组优、良的总数为33例,其总优良率91.67%明显高于对照组68.76%,差异有统计学意义(P<0.05)。结论相较于传统椎板开窗髓核切除手术来说,经皮椎间孔镜辅助下椎间盘切除术能明显减少出血量,减少并发症的发生,提升手术效果,促进患者的康复,值得临床推广。

Objective To investigate the effect of modified percutaneous foraminoscope assisted discectomy for lumbar disc herniation.Methods A total of sixty-eight patients with lumbar disc herniation admitted to Tangshan People's Hospital from June 2018 to June 2021 were selected as the observation subjects,and they were divided into control group(n=32)and observation group(n=36)according to different in surgical procedures.The control group was treated with minimally invasive laminectomy.The observation group underwent modified percutaneous interforaminal assisted discectomy.Compare two groups of patients who related indicators(length of incision、blood loss、hospital time、down time),to compare two groups of preoperative and postoperative six months visual analogue scale(VAS)、dysfunction index score(ODI)、compared two groups of surgical complications(infection、constipation、urinary retention、hyperalgesia),surgical treatment effect of(6 months).Results The intraoperative and postoperative related indicators of the observed group were significantly shorter or less than those of the control group,and all the differences were all statistically significant(P<0.05);Six months after treatment,VAS score and ODI score in the observation group were significantly lower than those in the control group,with statistical significance(P<0.05);After treatment,the complication rate of bleeding infection,constipation,urinary retention and hyperalgesia in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05);After treatment,thirty-three cases were excellent,good and poor in the observation group,and the total excellent and good rate of 91.67%was significantly higher than that of 68.76%in the control group,with statistical significance(P<0.05).Conclusion Compared with minimally invasive laminar fenestration,modified percutaneous foraminoscope-assisted discectomy can significantly reduce the amount of blood loss,reduce the incidence of complications,improve the surgical effect,and promote the rehabilitation of patients,which is worthy of clinical promotion.