摘要
目的探究椎间孔镜手术治疗腰椎间盘突出症(lumbar disc herniation,LDH)患者的效果.方法选取该院2020年1—12月收治的90例LDH患者,进行前瞻性随机平行对照研究,按随机数字表法将其分为A组(n=45)、B组(n=45).B组接受开窗髓核摘除术(fenestration discectomy,FD)治疗,A组接受椎间孔镜下髓核摘除术(percutaneous transforaminal endoscopic discectomy,PTED)治疗.对比两组的手术指标、手术效果、Oswestry功能障碍指数(Oswestry disability index,ODI)评分及神经递质指标[一氧化氮(nitric oxide,NO)、5-羟色胺(5-hydroxytryptamine,5-HT)]水平.结果A组的术中失血量少于B组,手术时间、切口长度短于B组,组间差异有统计学意义(P<0.05).A组的优良率为95.56%,高于B组的77.78%,差异有统计学意义(P<0.05).A组术后3 d的血清NO、5-HT水平均低于B,组间差异有统计学意义(P<0.05).A组术后1、3个月ODI评分均低于B组,组间差异有统计学意义(P<0.05).结论与传统FD治疗相比,采用PTED治疗LDH患者,于优化手术指标、提升手术效果、减轻术后疼痛感、改善腰椎功能方面更具优势.
Objective To evaluate the efficacy of intervertebral foraminal endoscopic surgery for lumbar disc herniation(LDH).Methods A total of 90 LDH patients admitted to the hospital from January to December 2021 were selected for a prospective randomized parallel control study.They were randomly divided into group A(n=45)and group B(n=45)according to random number table.Group B was treated with fenestration discectomy(FD),and group A was treated with percutaneous transforaminal discectomy(PTED).The surgical indicators,surgical outcomes,and Oswestry disability index(ODI),and levels of the neurotransmitter[nitric oxide(NO)and 5-hydroxytryptamine(5-HT)]were compared between the two groups.Results The intraoperative blood loss in group A was less than that in group B,and the operative time and incision length were shorter than that in group B,the differences between the two groups were statistically significant(P<0.05).The excellent and good rate of group A was 95.56%,which was higher than 77.78%of group B,and the difference was statistically significant(P<0.05).The serum levels of NO and 5-HT in group A were lower than those in group B at 3 days after operation,and the differences between the groups were statistically significant(P<0.05).The ODI scores of group A were lower than those of group B at 1 and 3 months after operation,and the differences between the two groups were statistically significant(P<0.05).Conclusion Compared with traditional FD treatment,PTED treatment for LDH patients has more advantages in optimizing surgical indicators,improving surgical effects,alleviating postoperative pain and improving lumbar function.
作者
吴启泽
韦国平
WU Qize;WEI Guoping(Department of Spinal Surgery,Laibin People's Hospital,Laibin Guangxi,546100,China)
出处
《反射疗法与康复医学》
2021年第15期111-113,共3页
Reflexology And Rehabilitation Medicine
关键词
开窗髓核摘除术
腰椎功能
腰椎间盘突出症
椎间孔镜手术
Fenestration discectomy
Lumbar function
Lumbar disc herniation
Intervertebral foraminal endoscop
