单孔分体内镜技术与单侧双通道内镜技术治疗 腰椎间盘突出症的临床疗效对比分析

Comparative Analysis of Clinical Efficacy Between Single Hole Split Endoscopy and Unilateral Dual Channel Endoscopy in the Treatment of Lumbar Disc Herniation

目的对比分析单孔分体内镜(One-Hole Split Endoscope,OSE)技术和单侧双通道内镜(Unilateral Biportal Endoscopy,UBE)技术治疗腰椎间盘突出症(Lumbar Disc Herniation,LDH)的早期临床疗效。方法回顾分析2021年8月—2022年9月巨野县人民医院、杭州市中医院及东明县人民医院收治且符合选择标准的54例LDH患者,其中,26例采用OSE术治疗(OSE组),28例采用UBE术治疗(UBE组)。对比两组手术时间、术中出血量、疼痛情况、术后住院时间及恢复优良率。结果所有患者均顺利完成手术,OSE组与UBE组术中出血量、手术时间、切口长度、术后住院时间比较,差异均无统计学意义(P>0.05)。观察对比两组患者术后3个月、6个月及12个月时随访情况,两组间腰腿痛VAS评分和ODI评分差异均无统计学意义(P>0.05)。但随着时间的推移,组内腰腿痛VAS评分和ODI评分均显著减少,各时间点比较,差异均有统计学意义(P<0.05)。UBE组术中均未发生硬膜囊撕裂、神经根损伤等并发症;OSE组术中发生刀口浅表感染1例。结论OSE与UBE治疗腰椎间盘突出症在术中出血量、手术时间、切口长度、术后住院时间等方面无明显差异,均可有效改善腰椎功能。

Objective To compare the early clinical efficacy of single hole split endoscopy(OSE)and unilateral dual channel endoscopy(UBE)in the treatment of lumbar disc herniation(LDH).Methods A retrospective analysis was conducted on 54 LDH patients admitted to Juye County People's Hospital、Hangzhou Traditional Chinese Medicine Hospital and Dongming County People's Hospital from August 2021 to September 2022,who met the selection criteria.Among them,26 cases were treated with OSE surgery(OSE group)and 28 cases were treated with UBE surgery(UBE group).The surgical time,intraoperative bleeding,pain,postoperative hospital stay,and recovery rate between two groups were evaluated and compared.Results All patients successfully completed the surgery,and there was no statistically significant difference in intraoperative bleeding,surgical time,incision length,and postoperative hospital stay between the OSE group and the UBE group(P>0.05).The follow-up results of two groups of patients at 3,6,and 12 months after surgery were observed and compared,there was no statistically significant difference in VAS and ODI for lower back and leg pain between the two groups(P>0.05).However,over time,the VAS and ODI scores for lower back and leg pain within the group significantly decreased,and the differences at each time point were statistically significant(P<0.05).No complications such as dural sac tear or nerve root injury occurred during surgery in the UBE group;One case of superficial infection of the incision occurred during surgery in the OSE group.Conclusion There is no significant difference between OSE and UBE in terms of intraoperative blood loss,surgical time,incision length,and postoperative hospital stay in the treatment of lumbar disc herniation,and both can effectively improve lumbar spine function.