CAJ | 학술논문

目的：比较后路显微内镜椎间盘切除术(MED)与自动经皮腰椎间盘切吸术(APLD)治疗腰椎间盘突出症的临床疗效。方法根据患者病情，按照资料方法将320例患者分为MED组和APLD组，并采取相应的治疗方法。比较两组手术时间、术中出血量、住院天数和临床疗效。结果 MED组和APLD组在手术时间、术中出血量、住院天数相比，差异无统计学意义(P>0.05)。MED组和APLD组治疗优良率分别为90.63%和90.99%,差异无统计学意义(χ2=1.077，P>0.05)。两组各有1例发生椎间盘炎，对症治疗后康复。患者整体恢复情况良好，均未出现术后复发再手术病、发生神经根损伤、术中大出血病例。结论 MED和APLD作为治疗腰椎间盘突出症的手术方法，在严格掌握手术适应证的情况下，疗效并没有明显差异。在临床实践中，务必要根据患者手术指证，选择合适的方法，获得更好的治疗效果。
목적：비교후로현미내경추간반절제술(MED)여자동경피요추간반절흡술(APLD)치료요추간반돌출증적림상료효。방법근거환자병정，안조자료방법장320례환자분위MED조화APLD조，병채취상응적치료방법。비교량조수술시간、술중출혈량、주원천수화림상료효。결과 MED조화APLD조재수술시간、술중출혈량、주원천수상비，차이무통계학의의(P>0.05)。MED조화APLD조치료우량솔분별위90.63%화90.99%,차이무통계학의의(χ2=1.077，P>0.05)。량조각유1례발생추간반염，대증치료후강복。환자정체회복정황량호，균미출현술후복발재수술병、발생신경근손상、술중대출혈병례。결론 MED화APLD작위치료요추간반돌출증적수술방법，재엄격장악수술괄응증적정황하，료효병몰유명현차이。재림상실천중，무필요근거환자수술지증，선택합괄적방법，획득경호적치료효과。
Objective To compare the clinical efficacy between posterior microendoscopic discectomy(MED)and automated percutaneous lumbar discectomy (APLD) in the treatment of lumbar disc herniation.Methods 320 cases of patients were divided into MED group and APLD group according to the patient’s condition and data method,and they were given appropriate treatment, respectively. The duration of operation, intraoperative blood loss,hospital day and clinical efficacy of two groups were compared. Results There were no statistically significant differences between MED group and APLD group in the duration of operation, intraoperative blood loss, hospital day, the difference was not statistically significant(P>0.05). The excellent and good rate of MED group and APLD group was 90.63%and 90.99%, respectively,there was no statistically significant difference between the two groups in efficacy(χ2=1.077,P>0.05,). Both groups had 1 case of discitis, and the patient recovered after symptomatic treatment. All the patients recovered well, no postoperative recurrence, nerve root injury,intraoperative bleeding cases occurred.Conclusion As the surgical treatment method for lumbar disc herniation, there is no significant difference in the clinical efficacy between MED and APLD on the basis of mastering the surgical indications strictly. In order to obtain better treatment effect,it is necessary to select appropriate method according to the patient’s surgical indications.