显微内窥镜下腰椎间盘突出症治疗

Clinical Evaluation of Microendoscopic Discectomy for Lumbar Disc Herniation

目的 对比研究MED法与Love法治疗腰椎间盘突出症的临床效果。 方法 1999年 12月以来手术治疗单一节段腰椎间盘突出 70例 ,其中MED法与Love法各 35例 ,比较手术前后JOA评分 ,术后改善率 ,手术切口长度 ,出血量 ,手术时间 ,髓核摘除量 ,术后发热 ,术后下地时间。 结果 术前JOA评分MED组与Love组分别为 12 .2± 1.8与 12 .1± 1.4(t=0 .437,p =0 .6 6 3) ;术后JOA分别为 2 6 .9± 1.6和 2 6 .1± 5 .3(t=1.80 ,p =0 .0 77) ;改善率分别为 87.8%和 83 .1% (t=1.84,p =0 .0 6 9) ;手术切口长度分别为 (2 .0± 0 .1)cm和 (5 .0± 0 .6 )cm(t=2 6 .72 1,p <0 .0 0 1) ;出血量分别为 (41± 12 )ml和 (6 9± 15 )ml(t =11.16 7,p <0 .0 0 1) ;手术时间分别为 (6 9± 15 )分钟和 (5 6± 9)分钟 (t=4.0 5 7,p <0 .0 0 1) ;最高体温分别为 (36 .8± 0 .1)℃和 (37.5± 0 .3)℃ (t=10 .80 ,p <0 .0 0 1) ;髓核摘除量分别为 (1.6± 0 .4)g和 (2 .2± 0 .4)g(t=8.40 ,p <0 .0 0 1) ;术后下地时间分别为 (1±0 .5 )天和 (2 .5± 0 .5 )天 (t=11.95 ,p <0 .0 0 1)。 结论 MED组与Love组均取得了满意的效果 ,MED手术具有创伤小 ,恢复快。

Objective To compare the therapeutic effect of Microendoscopic Discectomy (MED) with love's method for the treatment of lumbar disk herniation. Methods Pre- and postoperative JOA score, the length of incision, blood lost, operative time existed weight of disk, body temperature variation and time on getting out of bed after operation were compared between the MED group and the love's method group randomized 35 cases respectively since December 1999. Results The preoperative JOA scores in the MED group and the love's method group were 12.1±1.8 and 12.1±1.4, respectively (t=0.437, P=0.663); The postoperative JOA scores in both groups were 26.9±1.6 and 26.1±5.3, respectively (t=1.81, P=0.0077); The length of incision were (2.0±0.1)cm and (5.0±0.6)cm, respectively (t=26.72, P<0.001); The rate of improved JOA score were 87.7% and 83.1%, respectively (t=1.84, P=0.069); Blood loss were (4.1±12)ml and (69±15)ml, respectively (t=11.67, P<0.001); operative time (69.5±15)min and (56±9)min, respectively (t=4.06, P<0.001); The highest body temperature were (36.8±0.1)℃ and (37.5±0.3)℃, respectively (t=10.08, P<0.01); The time one getting out of bed after surgery were (1±0.5) days and (2.5±0.5) days, respectively (t=11.95, P<0.001). Conclusions Both the MED method and the love method can obtain the same satisfied results of therapy, but the MED method has advantages of minimal invasion and shorter time of recovery.