经皮椎间孔镜对腰椎间盘突出症的疗效及对患者疼痛程度和并发症的影响

The efficacy of percutaneous foraminal endoscopy on lumbar disc herniation and its impact on the degree of pain and complications in patients

目的探究经皮椎间孔镜对腰椎间盘突出症的疗效及对患者疼痛程度和并发症的影响。方法选取2019年1月至2022年1月九江市第一人民医院八里湖总院收治的80例腰椎间盘突出症患者作为研究对象,随机分为A组与B组,每组40例。A组行开放手术,B组经皮椎间孔镜技术治疗,比较两组手术及康复相关指标、疼痛程度、腰椎功能及术后并发症发生率。结果B组手术时间长于A组,术中出血量少于A组,卧床休息时间、住院时间均短于A组,差异有统计学意义(P<0.05)。术前、术后5d,两组视觉模拟评分法(VAS)评分比较差异无统计学意义;术后1、3d,B组VAS评分低于A组,差异有统计学意义(P<0.05)。术前、术后3个月,两组Oswestry功能障碍指数(ODI)、日本骨科学会(JOA)评分比较差异无统计学意义;术后3个月,两组ODI评分均低于术前,JOA评分均高于术前,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义。结论经皮椎间孔镜技术治疗腰椎间盘突出症疗效确切,与开放手术治疗方案相比,可减少术中出血量,降低术后疼痛程度,改善腰椎功能,值得临床推广应用。

Objective To explore the efficacy of percutaneous foraminal endoscopy on lumbar disc herniation and its impact on the degree of pain and complications in patients.Methods 80 patients with lumbar disc herniation admitted to the Balihu General Hospital of Jiujiang First Peo-ple's Hospital were selected as the study subjects,and they were randomly divided into the group A and the group B,with 40 cases in each group.Group A underwent open surgery,while group B underwent percutaneous transforaminal endoscopic treatment,the surgical and rehabilitation related indicators,degree of pain,lumbar spine function,and incidence of postoperative complications were compared between the two groups.Results The operation time in the group B was longer than that in the group A,the intraoperative blood loss was less than that in the group A,the bed rest time and hospital stay were shorter than those in the group A,and the differences were statistically significant(P<0.05).Before and 5 d after operation,there was no significant difference in visual analog scale(VAS)scores between the two groups;1 and 3 d after operation,the VAS score in the group B were lower than that in the group A,and the difference was statistically significant(P<0.05).There were no significant differences in the scores of Oswestry disability index(ODI)and Japanese Orthopaedic Society scores(JOA)between the two groups before surgery and 3 months after surgery;3 months after surgery,ODI and JOA scores of the two groups were lower than before surgery,and the differences were statistically significant(P<0.05).There was no significant difference in complication rate between the two groups.Conclusion Percutaneous intervertebral foramen endoscopic technique has definite efficacy on lumbar disc herniation,compared with open surgical treatment,it can reduce intraoperative bleeding and postopera-tive pain in patients,and is worthy of clinical promotion and application.