经皮内窥镜下髓核摘除术治疗腰椎间盘突出症临床效果研究

Clinical effect of percutaneous endoscopic extraction of nucleus pulposus in the treatment of lumbar disc herniation

目的探讨经皮内窥镜下髓核摘除术治疗腰椎间盘突出症的临床效果。方法选取自2022年7月至2023年10月期间在重庆医科大学附属永川医院骨科脊柱科收治的80例腰椎间盘突出症患者为研究对象,采用随机数字表法分为A组(n=40)与B组(n=40)。A组接受椎板开窗髓核摘除术,B组接受经皮内窥镜下髓核摘除术治疗。比较两组患者围术期相关指标、治疗前后Oswetry功能障碍指数评分(ODI)、视觉模拟评分(VAS)、疗效及术后并发症发生情况。结果与A组比较,B组切口长度短、术中出血量少,住院时间短,手术时间长,差异有统计学意义(P<0.05)。两组术后VAS评分、ODI评分较术前下降,B组较A组下降更明显,差异有统计学意义(P<0.05)。B组的疗效优于A组,并发症发生率低于A组,差异有统计学意义(P<0.05)。结论经皮内窥镜下髓核摘除术与椎板开窗髓核摘除术均能有效治疗腰椎间盘突出症,而经皮内窥镜下髓核摘除术疗效更好,并发症发生率低,术中出血量少,可缩短住院时间,减轻术后疼痛。

Objective To investigate the clinical effect of percutaneous endoscopic extraction of nucleus pulposus in the treatment of lumbar disc herniation.Methods A total of 80 patients with lumbar disc herniation admitted to the Orthopaedic Spine Department of Yongchuan Hospital Affiliated to Chongqing Medical University from July 2022 to October 2023 were selected as the study objects,and were divided into Group A(n=40)and Group B(n=40)by random number table method.The A group received fenestration of the laminae nucleus pulposus and the B group received percutaneous endoscopic extraction of nucleus pulposus.Perioperative indicators,Oswetry dysfunction index score(ODI),visual analogue score(VAS),efficacy evaluation and postoperative complications were statistically compared between the two groups.Results Compared with Group A,Group B had shorter incision length,less intraoperative blood loss,shorter hospital stay,and longer operation time,with statistically significant differences(P<0.05).Both groups showed a decrease in VAS and ODI scores after surgery compared with preoperative scores,but the decrease in Group B was more obvious,with statistically significant differences(P<0.05).The efficacy of Group B was better than that of Group A,and the incidence of complications was lower than that of Group A,with statistically significant differences(P<0.05).Conclusion Both laminae nucleus pulposus and percutaneous endoscopic extraction of nucleus pulposuscan effectively treat lumbar disc herniation.Minimally percutaneous endoscopic extraction of nucleus pulposus has better therapeutic effects,lower complication rate,less intraoperative blood loss,shorter hospital stay,and less postoperative pain.