Percutaneous endoscopic lumbar discectomy versus lumbar discectomy with vertebral fenestration in the treatment of lumbar disc herniation
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摘要: 目的 比较经皮椎间孔镜腰椎间盘切除术(PELD)与椎板开窗腰椎间盘切除术治疗腰椎间盘突出症的效果。 方法 将200例腰椎间盘突出症患者随机分为2组各100例。对照组采用椎板开窗腰椎间盘切除术治疗,研究组采用PELD治疗。比较2组疗效。 结果 研究组手术时间、下床活动时间、住院时间、术中出血量、切口长度均显著优于对照组(P<0.05)。术后3、6个月时,研究组Oswestry功能障碍指数(ODI)显著低于对照组(P<0.05)。治疗后,研究组MacNa优良率为92.00%, 显著高于对照组的82.00%(P<0.05)。研究组术后并发症发生率显著低于对照组(P<0.05)。 结论 PELD治疗腰椎间盘突出症安全、有效,具有创伤小、出血少、恢复快、并发症少等特点,可改善腰椎功能。
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关键词:
- 腰椎间盘突出症 /
- 经皮椎间孔镜腰椎间盘切除术 /
- 椎板开窗腰椎间盘切除术 /
- Oswestry功能障碍指数 /
- 手术时间 /
- 并发症
Abstract: Objective To compare the effect of percutaneous endoscopic lumbar discectomy(PELD)and lumbar discectomy with vertebral?fenestration in the treatment of lumbar disc herniation. Methods A total of 200 patients with lumbar disc herniation were randomly divided into two groups, with 100 cases in each group. Control group was treated by lumbar discectomy with vertebral fenestration, while study group was treated by PELD. The efficacy was compared between two groups. Results The operation time, time to get out of bed for activity, hospitalization time, intraoperative bleeding volume and incision length of the study group were significantly better than those of the control group(P<0.05). At 3 and 6 months after operation, the Oswestry dysfunction index(ODI)in the study group was significantly lower than that in the control group(P<0.05). After treatment, the excellent and good rate of MacNa in the study group was 92.00%, which was significantly higher than 82.00% in the control group(P<0.05). The incidence rate of postoperative complications in the study group was significantly lower than that in the control group(P<0.05). Conclusion PELD is safe and effective in the treatment of lumbar disc herniation, which has the characteristics of less trauma, less bleeding, fast recovery and fewer complications, and it can improve lumbar function. -
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周谋望, 岳寿伟, 何成奇, 等. “腰椎间盘突出症的康复治疗”中国专家共识[J]. 中国康复医学杂志, 2017, 32(2): 129-135. 凌华军, 范磊, 赖茂松, 等. 椎间盘镜与椎间孔镜治疗腰椎间盘突出疗效比较的Meta分析[J]. 中国内镜杂志, 2017, 23(3): 47-55. 张培, 吴小涛, 高增鑫. 侧路椎间孔镜与后路椎间盘镜治疗腰椎间盘突出症疗效比较[J]. 中国矫形外科杂志, 2019, 27(15): 1355-1359. 饶美林, 肖洪波. 常见病康复诊疗规范—腰椎间盘突出症康复规范管理与分级诊疗[J]. 安徽医学, 2017, 38(9): 148-149. 张坡, 王运涛, 洪鑫, 等. 经皮内窥镜下腰椎间盘切除术治疗腰椎间盘突出症术后再手术的危险因素分析[J]. 中国脊柱脊髓杂志, 2019, 29(4): 319-324. 丁海蛟, 王天胜, 付雷, 等. 经皮椎间孔镜下椎间盘切除术治疗腰椎间盘突出症效果观察[J]. 临床军医杂志, 2018, 46(9): 1081-1082. 张明博, 黄鹏, 武成志, 等. 单纯超声引导下经皮椎间孔镜腰椎间盘切除术一例[J]. 中华腔镜外科杂志, 2019, 12(2): 111-114. 姜劲挺, 郑吉元, 李振豪, 等. 基于“疏肝补肾”法治疗骨质疏松并腰椎间盘突出症的思路探析[J]. 中国中医基础医学杂志, 2017, 23(3): 367-370. 陈康, 李克乾, 易剑华, 等. 经皮椎间孔镜下髓核切除术与小切口椎板间开窗髓核摘除术 治疗腰椎间盘突出症患者对比研究[J]. 河北医学, 2019, 25(3): 630-635. 金丹杰, 徐南伟, 赵国辉, 等. 经皮椎间孔镜与椎板开窗椎间盘切除术治疗腰椎间盘突出症的前瞻性随机对照研究[J]. 中国微创外科杂志, 2017, 17(6): 491-494. 赵晓东, 邓立明, 王建波, 等. 椎间孔镜与椎间盘镜治疗腰椎间盘突出症5年疗效比较[J]. 中国微创外科杂志, 2019, 19(8): 684-687 , 701.
何玉宝, 徐林, 任龙喜, 等. 糖尿病对腰椎间盘突出症经皮椎间孔镜下椎间盘切除术后疗效的影响[J]. 国际外科学杂志, 2019, 46(3): 176-181. 陈会平. 经皮椎间孔镜椎间盘切除术与椎板开窗椎间盘切除术治疗老年腰椎间盘突出症的近期疗效比较[J]. 颈腰痛杂志, 2018, 39(4): 522-523. 米盼盼, 陈胜乐, 许雅芳, 等. 经皮椎间孔镜椎间盘切除术对单阶段腰椎间盘突出患者ODI、MacNab优良率、Lehmann腰椎功能的影响[J]. 中国医药导报, 2018, 15(3): 70-72.
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