摘要
目的:探讨微创经皮椎板间入路手术对腰椎间盘突出症(lumbar disc herniation,LDH)患者神经根分离率和钙化清除率、腰椎功能和疼痛程度的影响。方法:选取2018年2月-2020年1月就诊于本院的86例LDH患者,按随机数字表法分为试验组(n=43)与对照组(n=43)。试验组行微创经皮椎板间入路手术,对照组行经皮椎间孔入路手术。对比两组围手术期相关指标、钙化清除率、神经根分离率、腰椎功能、腰椎疼痛及并发症发生情况。结果:两组术后住院时间比较,差异无统计学意义(P>0.05);试验组术中失血量、术中X线透视次数均低于对照组,手术用时短于对照组,差异均有统计学意义(P<0.05)。两组术后3 d钙化清除率和神经根分离率比较,试验组均高于对照组,差异均有统计学意义(P<0.05)。两组术后3个月Oswestry功能障碍指数(ODI)评分、视觉模拟评分法(VAS)评分与术前相比均明显降低,差异均统计学意义(P<0.05),但两组比较差异均无统计学意义(P>0.05)。两组术后均未出现严重并发症。结论:微创经皮椎板间入路手术与经皮椎间孔入路手术均能有效改善LDH患者腰椎功能与疼痛程度,均具有较高的安全性。但前者手术时间短、失血量少、X线透视次数少,可提高钙化清除率、神经根分离率,值得临床推广应用。
Objective:To investigate the effects of minimally invasive percutaneous interlaminar approach surgery for patients with lumbar disc herniation(LDH)and nerve root separation rate and Calcification clearance rate,lumbar function and pain degree.Method:A total of 86 LDH patients admitted to our hospital from February 2018 to January 2020 were selected and divided into experimental group(n=43)and control group(n=43)according to the random number table method.The experimental group underwent minimally invasive percutaneous interlaminar approach surgery,while the control group underwent percutaneous transforaminal approach surgery.The perioperative related indexes,Calcification clearance rate,nerve root separation rate,lumbar spine function,lumbar spine pain and complications were compared between the two groups.Result:There was no significant difference in postoperative hospital stay between the two groups(P>0.05).The intraoperative blood loss and frequency of intraoperative X-ray fluoroscopy in the experimental group were all lower than those in the control group,the operative time was shorter than that in the control group,there were statistically significant differences(P<0.05).The Calcification removal rate and nerve root separation rate of the two groups at 3 d after operation were all higher compared with those of before operation(P<0.05),the experimental group were higher than those in the control group,there were statistically significant differences(P<0.05).Oswestry disability index(ODI)score and visual analogue scale(VAS)score of the two groups were significantly reduced 3 months after surgery compared with those before surgery,and the differences were statistically significant(P<0.05),but there were no statistically significant differences between two groups(P>0.05).There were no serious complications in both groups.Conclusion:Both minimally invasive percutaneous interlaminar approach and percutaneous transforaminal approach can effectively improve the lumbar function and pain degree of LDH patients,and bot
作者
李育敏
孙海东
李悫
钟锐
LI Yumin;SUN Haidong;LI Que;ZHONG Rui(Ganzhou Traditional Chinese Medicine Hospital,Ganzhou 341000,China)
出处
《中国医学创新》
CAS
2020年第30期49-52,共4页
Medical Innovation of China
基金
江西省卫生计生委中医药科研课题项目(2018A168)。
关键词
腰椎间盘突出症
经皮椎板间入路手术
腰椎功能
经皮椎间孔入路手术
钙化清除率
Lumbar disc herniation
Percutaneous interlaminar approach surgery
Lumbar function
Percutaneous transforaminal approach surgery
Calcification clearance rate
