多节段腰椎间盘突出症的经皮椎间孔技术干预疗效分析

Analysis of the therapeutic effect of percutaneous intervertebral foramen intervention in multi segment lumbar disc herniation

目的:探讨多节段腰椎间盘突出症(LDH)经过经皮椎间孔镜(PTED)技术治疗后的疗效,并评估其治疗安全性。方法:选取2021年4月至2023年4月鹤壁市第二人民医院收治的多节段LDH患者为研究对象,随机分为研究组和对照组。研究组(n=30)患者行一次性多节段PTED手术,对照组(n=30)患者行开放式手术。术后随访6个月,对两组疼痛程度(VAS)评分进行评价,比较两组腰椎功能障碍指数(DOI),评价总有效率与术后并发症发生情况。结果:术后1、3、6个月,两组患者的VAS、ODI评分呈现降低趋势,与对照组相比,研究组更低,差异有统计学意义(P<0.05)。与对照组73.33%、6.67%相比,研究组的总有效率更高,并发症发生率更低,分别为93.33%、6.67%(P<0.05)。结论:较开放式手术,PTED技术可以降低多节段LDH患者围术期内的疼痛感,改善腰椎功能,在整体上提高患者疗效,术后并发症更少,具有更高的安全性。

Objective:Exploring the efficacy of percutaneous transforaminal endoscopic(PTED)treatment for multi segment lumbar disc herniation(LDH)and evaluating its treatment safety.Methods:From April 2021 to April 2023,patients with multi-level LDH admitted to the The Second People's Hospital of Hebi City were selected as the study objects.Randomized into study and control 2 groups.The patients(n=30)in the study group underwent one-off multi-stage pted operation,while those in the control group(n=30)underwent open surgery.After follow-up for 6 months to observe and compare the degree of pain,lumbar spine function and efficacy.Results:At 1,3 and 6 months after operation,the visual analog score(VAS score)and Oswestry lumbar spine dysfunction index(ODI)were lower than the preoperative level,and the overall pain level was lower in the study group compared with the control group,with a statistically significant difference(P<0.05).The total excellent and good rate of the study group was 93.33%(28/30),higher than 73.33%(22/30)of patients in the control group(P<0.05).The incidence of postoperative complications in the study group was 6.67%(2/30),lower than 26.67%(8/30)of patients in the control group(P<0.05).Conclusion:Compared to open surgery,percutaneous fenestral endoscopy technology can reduce the pain of the lumbar spine during the perioperative period in multi segment LDH patients,improve lumbar function,and overall improve patient efficacy with fewer postoperative complications and higher specific safety.