摘要
目的比较经皮椎间孔镜下经椎间孔脊柱内镜系统(TESSYS)和椎板开窗髓核摘除术(FD)治疗单节段钙化型腰椎间盘突出症(LDH)患者的临床疗效。方法回顾性分析2020年1月至2021年12月河南省直第三人民医院收治的105例单节段钙化型LDH患者的临床诊治资料,根据治疗术式不同分为TESSYS术组53例和FD术组52例。比较两组患者围术期指标、炎性反应相关指标[肿瘤坏死因子α(TNF-α)、白细胞介素-10(IL-10)、IL-6]、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)]、胫总神经、腓总神经的潜伏期(DL)、传导速度(NCV)、腰椎功能评分(ODI)、疼痛程度评分(VAS)和并发症发生情况。结果TESSYS术组患者术中出血量为(38.53±9.61)m L,明显低于FD术组的(219.84±21.50)m L,切口长度为(0.59±0.17)cm,明显小于FD术组的(4.15±1.69)cm,手术用时、术后首次下床时间、住院时间分别为(1.05±0.48)h、(1.74±0.62)d、(6.38±1.47)d,明显短于FD术组的(1.64±0.72)h、(3.49±0.86)d、(10.35±2.03)d,差异均有统计学意义(P<0.05);术后1 d、3 d,两组患者的血清TNF-α、IL-10、IL-6、MDA水平均呈先升高后降低的趋势,而SOD、GSH-Px水平呈现先降低后升高的趋势,但TESSYS术组患者的血清TNF-α、IL-10、IL-6、MDA、SOD、GSH-Px水平波动小于FD术组,差异均有统计学意义(P<0.05);术后1个月、3个月,两组患者的胫总神经和腓总神经的DL呈逐渐降低趋势,NCV呈逐渐升高趋势,且TESSYS术组患者胫总神经和腓总神经的DL、NCV改善程度明显优于FD术组,差异均有统计学意义(P<0.05);术后3个月、6个月、12个月,两组患者的ODI、VAS评分均呈逐渐降低趋势,且TESSYS术组患者的ODI、VAS评分降低幅度明显大于FD术组,差异均有统计学意义(P<0.05);TESSYS术组患者术后并发症发生率为3.77%,明显低于FD术组的17.31%,差异有统计学意义(P<0.05)。结论经皮椎间孔镜下TESSYS术应用于单�
Objective To compare the clinical efficacy of transforaminal endoscopic spine system(TESSYS)under percutaneous foraminiscope and fenestration discectomy(FD)in the treatment of single-segment calcified lumbar disc herniation(LDH).Methods Clinical diagnosis and treatment data of 105 patients with single-segment calcified LDH admitted to the Third People's Hospital of Henan Province from January 2020 to December 2021 were analyzed retrospectively.They were divided into TESSYS group(n=53)and FD group(n=52)according to different treatment methods.After operation,the perioperative indexes and inflammatory reaction indexes[(tumor necrosis factor-α(TNF-α),interleukin-10(IL-10),IL-6],oxidative stress indexes[malondialdehyde(MDA),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)],latency(DL),and conduction velocity(NCV)of common tibial nerve and common peroneal nerve,lumbar function score(ODI),pain score(VAS)and complications were compared between the two groups.Results The intraoperative bleeding volume of TESSYS group was(38.53±9.61)mL,which was significantly lower than(219.84±21.50)mL of FD group;the incision length was(0.59±0.17)cm,which was significantly smaller than(4.15±1.69)cm of FD group;the operation time,the first time of getting out of bed after operation,and the length of hospital stay were(1.05±0.48)h,(1.74±0.62)d,(6.38±1.47)d,respectively,which were significantly shorter than(1.64±0.72)h,(3.49±0.86)d,and(10.35±2.03)d in FD group;the differences were statistically significant(P<0.05).After 1 day and 3 days of operation,the serum levels of TNF-α,IL-10,IL-6,and MDA in two groups were firstly increased and then decreased;the levels of SOD and GSH-Px were firstly decreased and then increased;the levels of TNF-α,IL-10,IL-6,MDA,SOD,and GSH-Px in TESSYS group were significantly lower than those in FD group;the differences were statistically significant(P<0.05).After 1 month and 3 months of operation,the DL of the common tibial nerve and common peroneal nerve in the two groups showed a gradually
作者
李媛媛
祝盼盼
肖杰
李芳
郭强
LI Yuan-yuan;ZHU Pan-pan;XIAO Jie;LI Fang;GUO Qiang(Department of Intervertebral Disc Diseases,the Third People's Hospital of Henan Province,Zhengzhou 450000,Henan,CHINA;Department of Orthopaedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA;Department of Orthopedics,Zhengzhou Central Hospital,Zhengzhou 450007,Henan,CHINA)
出处
《海南医学》
CAS
2023年第14期2006-2011,共6页
Hainan Medical Journal
基金
河南省医学科技攻关计划(联合共建)项目(编号:LHGJ20190535)。
关键词
腰椎间盘突出症
椎间孔镜
椎间孔脊柱内镜系统
椎板开窗髓核摘除术
神经传导速度
临床疗效
Lumbar disc herniation
Foraminal lens
Foraminal spinal endoscopic system
Lamina fenestration of nucleus pulposus
Nerve conduction velocity
Clinical effect
