摘要
目的探讨经皮椎间孔镜椎间盘切除术(PTED)治疗腰椎间盘突出症(LDH)后白细胞介素-10(IL-10)、白细胞介素-8(IL-8)及P物质(SP)水平的变化及其与神经功能恢复的关系。方法选取2022年1月至2024年1月保定市第一中心医院收治的131例LDH患者,按照不同治疗术式分为对照组[传统开窗减压髓核摘除术(ODD),n=65)]、试验组(PTED,n=66),比较两组围手术期指标、术前、术后3个月腰椎活动功能(腰椎前屈、后伸、左侧屈、右侧屈活动度)、疼痛程度[视觉模拟评分法评分(VAS)]、脊柱功能[腰椎Oswestry功能障碍指数(ODI)]、腰背肌生物力学性能[腰背屈伸比(F/E)、伸展平均功率(AP)、峰力矩(PT)]、实验室指标(IL-10、IL-8及SP水平)及并发症发生率。结果试验组手术、住院、下床时间、切口长度短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。两组术后3个月腰椎前屈、后伸、左侧屈、右侧屈活动度均升高,且试验组高于对照组,差异有统计学意义(P<0.05)。两组术后3个月VAS、ODI评分均下降,且试验组低于对照组,差异有统计学意义(P<0.05)。两组术后3个月的AP、PT均升高,且试验组高于对照组,两组术后3个月的F/E均降低,且试验组低于对照组,差异有统计学意义(P<0.05)。两组术后3 d的IL-10、IL-8及SP水平均降低,且试验组低于对照组,差异有统计学意义(P<0.05)。试验组并发症总发生率(7.57%)明显比对照组并发症总发生率(20.00%)低,差异有统计学意义(P<0.05)。Pearson相关性分析显示:PTED治疗腰椎间盘突出症后IL-8及SP水平与ODI评分呈正相关关系,IL-10水平与ODI评分呈负相关关系(P<0.05)。结论相较于ODD,PTED治疗LDH疗效更佳,可有效促进患者神经功能恢复,降低血清IL-10、IL-8、SP水平。
Objective To investigate the changes of interleukin-10(IL-10),interleukin-8(IL-8)and substance P(SP)levels after percutaneous transforaminal endoscopic discectomy(PTED)in the treatment of lumbar disc herniation(LDH)and their relationship with the recovery of neurological function.Methods A total of 131 patients with LDH admitted to Baoding First Central Hospital from January 2022 to January 2024 were selected and divided into a control group[traditional fenestration decompression nucleus pulposus removal(ODD),n=65)]and an experimental group(PTED,n=66)based on different treatment methods.The perioperative indexes,lumbar motion function(lumbar flexion,extension,left flexion and right flexion),pain degree[visual analogue scale(VAS)],spinal function[lumbar Oswestry dysfunction index(ODI)],biomechanical properties of low back muscle[lumbar dorsiflexion and extension ratio(F/E),average extension power(AP),peak torque(PT)],laboratory indicators(IL-10,IL-8,and SP levels)and incidence of complications were compared between the two groups before and 3 months after operation.Results The experimental group had shorter surgery time,hospitalization time,time out of bed and incision length and less intraoperative bleeding than those of the control group,with statistically significant differences(P<0.05).The lumbar flexion,extension,left flexion and right flexion of the two groups increased at 3 months after operation,and the experimental group was higher than the control group,the difference was statistically significant(P<0.05).The VAS and ODI scores of the two groups decreased at 3 months after operation,and the experimental group was lower than the control group,the difference was statistically significant(P<0.05).The AP and PT of the two groups increased at 3 months after operation,and the experimental group was higher than the control group.The F/E of the two groups decreased at 3 months after operation,and the experimental group was lower than the control group.The difference was statistically significant(P<0.05).The leve
作者
杨朔
刘智伟
白晓亮
康亚娟
陆芳
孔亚荣
薛广
YANG Shuo;LIU Zhiwei;BAI Xiaoliang;KANG Yajuan;LU Fang;KONG Yarong;XUE Guang(Department of Orthopedics,Baoding First Central Hospital,Baoding,Hebei,China,071000;Hospital office,Baoding First Central Hospital,Baoding,Hebei,China,071000;Department Second of Ultrasound,Baoding First Central Hospital,Baoding,Hebei,China,071000)
出处
《分子诊断与治疗杂志》
2024年第10期1827-1831,共5页
Journal of Molecular Diagnostics and Therapy
基金
河北省医学科学研究课题计划项目(20220292)
保定市科技计划项目(2441ZF030)。
