摘要
目的探讨显微镜辅助通道下腰椎间盘髓核摘除术(MSLD)治疗腰椎间盘突出症(LDH)的效果。方法选取2016年2月~2018年4月粤北人民医院收治的LDH患者105例。根据手术方法的不同将患者分为椎板间入路经皮穿刺脊柱内镜腰椎间盘摘除术(IL-PELD)组(n=52,给予IL-PELD术式)和MSLD组(n=53,给予MSLD术式),记录两组患者手术时间、术中出血量、手术切口长度、术中透视次数、术后住院时间、并发症发生率。观察两组患者治疗后临床疗效。记录两组患者术前、术后1 d、术后1个月、术后3个月、术后6个月的视觉模拟评分(VAS)、Osweatry功能障碍指数(ODI)评分情况。结果两组患者手术切口长度、术后住院时间比较差异无统计学意义(P> 0.05)。MSLD组手术时间长于IL-PELD组,术中出血量、术中透视次数少于IL-PELD组,并发症发生率低于IL-PELD组(P <0.05)。两组临床总有效率比较差异无统计学意义(P> 0.05)。两组患者术前、术后1 d、术后1个月、术后3个月、术后6个月VAS、ODI评分同期比较差异无统计学意义(P> 0.05)。两组患者术后1 d、术后1个月、术后3个月、术后6个月VAS、ODI评分均较术前降低,且各时间点呈依次下降趋势(P <0.05)。结论与传统手术比较,MSLD治疗LDH,虽然获得的疗效相当,但其可以有效减少术中出血量、术中透视次数,降低并发症发生率,值得进一步的临床推广。
Objective To investigate the effect of microscopically assisted lumbar discectomy(MSLD) in the treatment of lumbar disc herniation(LDH). Methods One hundred and five cases of LDH admitted to Yuebei People′s Hospital from February 2016 to April 2018 were selected. The patients were divided into percutaneous intervertebral disc percutaneous endoscopic lumbar discectomy(IL-PELD) group(n = 52, given IL-PELD) and MSLD group(n = 53, given MSLD). The operation time, intraoperative bleeding volume, incision length, fluoroscopy times, hospitalization time and complication rate were recorded. The clinical efficacy of the two groups after treatment was observed. The visual analogue score(VAS) and Osweatry dysfunction index(ODI) were recorded before operation, 1 d, 1 month, 3 months and6 months after operation. Results There was no significant difference in incision length and hospitalization time after operation between two groups(P > 0.05). The operation time of MSLD group was longer than that of IL-PELD group;the amount of bleeding, the number of fluoroscopy in MSLD group were less than those in IL-PELD group;the incidence of complication in MSLD group was lower than that in IL-PELD group(P < 0.05). The total effective rate of two groups was not statistically significant(P > 0.05). There was no significant difference in VAS and ODI scores between two groups before operation, 1 d after operation, 1 month after operation, 3 months after operation and 6 months after operation at the same period(P > 0.05). The VAS and ODI scores of two groups were lower than those 1 d, 1 month, 3 months and 6 months after the operation, and presented a trend of decrease with time(P < 0.05). Conclusion Compared with the traditional operation, MSLD can effectively reduce the amount of bleeding, the number of fluoroscopy and the incidence of complications. It is worthy of further clinical application.
作者
朱文刚
朱李贞
张志鹏
陈瑜
陈影
戴相恒
吴强
ZHU Wengang;ZHU Lizhen;ZHANG Zhipeng;CHEN Yu;CHEN Ying;DAI Xiangheng;WU Qiang(Department of Orthopedics, Yuebei People′s Hospital, Guangdong Province, Shaoguan 512026, China)
出处
《中国医药导报》
CAS
2019年第18期77-80,共4页
China Medical Herald
基金
广东省自然科学基金项目(2014B031508020)
广东省韶关市卫生计生科研项目(Y18034)
