脊柱内镜术后局部或静脉应用地塞米松的疗效探究

Clinical Efficacy of Local or Intravenous Dexamethasone after Lumbar Endoscopic Discectomy

比较脊柱内镜治疗腰椎间盘突出症手术后局部和静脉应用地塞米松的疗效。将82例有手术指征的腰椎间盘突出症患者随机分为实验组(局部应用地塞米松)和对照组(静脉应用地塞米松),各41例。两组分别有3例和4例患者失随访,其余75例患者平均随访时间498 d。两组手术时间、住院天数无统计学差异(P>0.05)。两组术后VAS评分较术前明显降低,差异有统计学意义(P<0.05);术后各时间节点的ODI评分较术前也显著下降(P<0.05)。术后,两组在各时间节点的VAS评分、ODI评分以及疗效分级均无统计学差异(P>0.05)。结果表明,脊柱内镜手术是治疗腰椎间盘突出症安全、有效、微创的方法,术后硬膜外局部应用和静脉应用地塞米松对疗效的影响无明显差异。

The efficacy of local dexamethasone and intravenous dexamethasone after lumbar endoscopic surgery was compared in this paper.A total of 82 cases of lumbar disc herniation with indications for lumbar endoscopic surgery were randomly divided into experimental group(n=41)and control group(n=41).75 patients were followed up for 498 d on average with exception of 3 patients in the former group and 4 patients in the latter group.The results show no statistical difference concerning operation time or hospitalization time between the two groups(P>0.05).The VAS scores after operation are significantly lower than those before operation,and the difference is significant(P<0.05).The ODI scores at each follow-up point after surgery are also significantly lower than those before treatment(P<0.05).There is no significant difference in VAS score,ODI score and efficacy grading standard between the two groups at each time point after treatment(P>0.05).Therefore,lumbar endoscopic discectomy proves to be a safe,effective and minimally invasive treatment for lumbar disc herniation.No significant difference in efficacy is shown between postoperative epidural local dexamethasone and intravenous dexamethasone.