经椎板间入路椎间孔镜下椎间盘切除术与开放手术治疗腰椎间盘突出症疗效比较

doi:10.3969/j.issn.1671-7171.2022.01.007

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摘要【目的】观察经椎板间入路椎间孔镜下椎间盘切除术(PTED)与开放手术治疗腰椎间盘突出症的效果。【方法】选取安康市人民医院脊柱外科2014年1月至2018年12月收治的腰椎间盘突出症患者80例,根据手术方式不同分为两组,每组40例。对照组给予传统开放手术,观察组给予PTED手术,比较两组患者的临床疗效。【结果】观察组术中出血量为(38.63±8.12)mL,少于对照组的(102.52±18.66)mL,切口长度为(0.90±0.23)cm,短于对照组的(4.12±0.85)cm,其差异有统计学意义(P<0.05)。两组患者术前血清白细胞介素-1β(IL-1β)、白细胞介素-17(IL-17)、5-羟色胺(5-HT)组间比较,差异无统计学意义(P>0.05)。观察组患者术后72 h上述血清因子明显低于对照组(P<0.05)。两组患者术前视觉模拟(VAS)评分组间比较,差异无统计学意义(P>0.05)。观察组患者术后3 d、出院时及术后6个月时VAS评分显著低于对照组(P<0.05)。所有患者均获得随访,观察组术后6个月时优良率为90.00%,显著高于对照组,差异有统计学意义(P<0.05)。【结论】PTED相较于开放手术应用于腰椎间盘突出症具有创伤小,恢复快,疼痛轻的优势。

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	张淋霖
	秦国良

关键词 ：椎间盘移位/外科学, 腰椎/外科学, 椎间盘切除术,经皮, 治疗结果

Abstract：【Objective】To compare endoscopic discectomy through intervertebral foramen via interbody approach (PTED) and open surgery in the treatment of lumbar disc herniation. 【Methods】A total of 80 patients with lumbar disc herniation treated in our hospital from January 2014 to December 2018 were divided into two groups according to different surgical methods, with 40 cases in each group. The control group was given traditional open laminectomy and the observation group was given vertebral pted surgery. The clinical effects of the two groups were compared.【Results】The intraoperative blood loss in the observation group was (38.63±8.12) mL, less than (102.52±18.66) mL in the control group, the incision length was (0.90±0.23) cm, shorter than (4.12±0.85) cm in the control group, the difference was statistically significant (P<0.05). There was no significant difference in the levels of interleukin-17 (IL-17) and 5-hydroxytryptamine (5-HT) (P>0.05). The levels of IL-17 and 5-HT in the control group were lower than those in the control group, The difference was statistically significant (P<0.05). There was no significant difference in preoperative visual analogue (VAS) scores between the two groups (P>0.05). The VAS scores of the observation group were significantly lower than those of the control group at 3 days, discharge and 6 months after operation (P<0.05). All patients were followed up. The excellent and good rate in the observation group was 90.00% at 6 months after operation, which was significantly higher than 72.50% in the control group (P<0.05). 【Conclusion】Compared with open surgery, pted has the advantages of less trauma, rapid recovery and less pain, and is worthy of clinical application.

Key words： Intervertebral Disc Displacement/SU Lumbar Vertebrae/SU Diskectomy, Percutaneous Treatment Outcome

收稿日期: 2021-01-22

中图分类号:

R681.53

通讯作者: *E-mail:328206581@qq.com

引用本文:

张淋霖, 秦国良. 经椎板间入路椎间孔镜下椎间盘切除术与开放手术治疗腰椎间盘突出症疗效比较[J]. 医学临床研究, 2022, 39(1): 26-29.
ZHANG Lin-lin, QIN Guo-liang. Comparison of Therapeutic Effects on Endoscopic Discectomy Through Intervertebral Foramen via Interbody Approach and Open Surgery in the Treatment of Lumbar Disc Herniation. JOURNAL OF CLINICAL RESEARCH, 2022, 39(1): 26-29.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.01.007 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I1/26

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