经皮椎间孔镜髓核摘除术在腰椎间盘突出症患者中的应用效果

Application effect of percutaneous transforaminal endoscopic discectomy for nucleus pulposus removal in patients with lumbar disc herniation

目的 探讨经皮椎间孔镜髓核摘除术治疗腰椎间盘突出症的效果。方法 选取2020年5月至2022年5月解放军联勤保障部队第九七○医院收治的70例腰椎间盘突出症患者为研究对象,采用随机数表法分为对照组和观察组,每组各35例。对照组行小切口椎板间开窗髓核摘除术治疗,观察组行经皮椎间孔镜髓核摘除术治疗。比较两组应激指标、炎症状况、日本骨科协会(JOA)评分、Oswsetry功能障碍指数(ODI)及影像学指标。结果 术后,观察组血清谷胱甘肽过氧化物酶、超氧化物歧化酶水平高于对照组,丙二醛水平低于对照组,差异有统计学意义(P <0.05);观察组白细胞介素-10水平高于对照组,肿瘤坏死因子-α、白细胞介素-6水平低于对照组,差异有统计学意义(P <0.05);观察组JOA评分高于对照组,ODI评分低于对照组,差异有统计学意义(P <0.05);两组影像学指标比较,差异无统计学意义(P> 0.05)。结论 腰椎间盘突出症采用经皮椎间孔镜髓核摘除术治疗效果较好,可有效改善患者应激指标水平,减轻机体炎症指标水平,促进腰椎功能恢复,利于患者病情预后,临床上可借鉴及推广。

Objective To evaluate the application effect of percutaneous transforaminal endoscopic discectomy for nucleus pulposus removal in patients with lumbar disc herniation.Methods A total of 70 patients with lumbar disc herniation from the 970th Hospital of PLA Joint Logistic Support Force from May 2020 to May 2022 were selected as the study subjects.They were randomly divided into the control group and the observation group using a random number table method,with 35 cases in each group.The control group received small incision intervertebral fenestration for nucleus pulposus removal,while the observation group received percutaneous transforaminal endoscopic discectomy for nucleus pulposus removal.The stress indicators,inflammatory status,Japanese Orthopaedic Association(JOA)score,Oswestry disability index(ODI),and imaging indicators were compared between the two groups.Results After operation,the serum levels of glutathione peroxidase and superoxide dismutase in the observation group were higher than the control group,while the levels of malondialdehyde were lower than the control group,with statistically significant differences(P<0.05).The level of interleukin-10 in the observation group was higher than the control group,and the level of tumor necrosis factor-αand interleukin-6 lower than the control group,with statistically significant differences(P<0.05).The JOA score of the observation group was higher than the control group,and the ODI score was lower than the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the comparison of imaging indexes between the two groups(P>0.05).Conclusion The treatment of lumbar disc herniation using percutaneous transforaminal endoscopic discectomy for nucleus pulposus removal has a good effect,can effectively improve the level of patients'stress indicators,reduce the level of inflammatory indicators,promote the recovery of lumbar vertebrae function,and is conducive to the prognosis of the patient's condition.This method can be used for reference and promotion in clinical practice.