中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
10期
1087-1090
,共4页
腰椎间盘突出症%经皮椎间孔镜手术%微创小切口
腰椎間盤突齣癥%經皮椎間孔鏡手術%微創小切口
요추간반돌출증%경피추간공경수술%미창소절구
Protrusion of lumbar intervertebral disc%Percutaneous transforaminal endoscopic discectomy%Minimal invasion with small incision
目的 探讨经皮椎间孔镜手术治疗腰椎间盘突出症的临床效果.方法 选择2012年11月至2013年11月在我院行手术治疗的腰椎间盘突出症患者60例,其中行经椎间孔镜治疗30例,行小切口椎板开窗髓核摘除术30例,对比分析两组患者的住院时间、术中出血量、手术切口长度、卧床时间以及术后24、48h视觉模拟评分,采用Oswestry功能障碍指数对两组患者术后72 h和术后1、6个月的日常生活能力进行评定.结果 椎间孔镜组在切口长度、术中出血量、术后卧床时间和住院时间方面明显优于小切口组[(0.7±0.2)、(4.9±0.2) cm,(11.6±2.2)、(102.9±16.3) ml,(27.5±8.2)、(94.1±19.7)d,(3.3±1.1)、(8.3±2.1)d],差异均有统计学意义(t值分别为81.332、30.403、17.095、.11.552,P均＜0.05),椎间孔镜组术后24、48、72 h视觉模拟评分明显低于小切口组[(3.7±1.2)、(6.8毒1.9)分,(2.1±1.1)、(5.3±1.6)分,(1.4±0.9)、(4.4±1.5)分],差异均有统计学意义(t值分别为7.555、9.026、9.393,P均＜0.05),术后1、6个月Oswestry功能障碍指数明显低于小切口组[12.1±4.7、18.6±3.6,5.4±2.3、13.2±2.7],差异有统计学意义(t值分别为6.013、12.045,P均＜0.05).结论 腰椎经皮椎间孔镜技术在手术切口、术中出血量、术后卧床和住院时间等方面具有明显优越性,对脊柱稳定结构破坏小,患者术后恢复快.
目的 探討經皮椎間孔鏡手術治療腰椎間盤突齣癥的臨床效果.方法 選擇2012年11月至2013年11月在我院行手術治療的腰椎間盤突齣癥患者60例,其中行經椎間孔鏡治療30例,行小切口椎闆開窗髓覈摘除術30例,對比分析兩組患者的住院時間、術中齣血量、手術切口長度、臥床時間以及術後24、48h視覺模擬評分,採用Oswestry功能障礙指數對兩組患者術後72 h和術後1、6箇月的日常生活能力進行評定.結果 椎間孔鏡組在切口長度、術中齣血量、術後臥床時間和住院時間方麵明顯優于小切口組[(0.7±0.2)、(4.9±0.2) cm,(11.6±2.2)、(102.9±16.3) ml,(27.5±8.2)、(94.1±19.7)d,(3.3±1.1)、(8.3±2.1)d],差異均有統計學意義(t值分彆為81.332、30.403、17.095、.11.552,P均＜0.05),椎間孔鏡組術後24、48、72 h視覺模擬評分明顯低于小切口組[(3.7±1.2)、(6.8毒1.9)分,(2.1±1.1)、(5.3±1.6)分,(1.4±0.9)、(4.4±1.5)分],差異均有統計學意義(t值分彆為7.555、9.026、9.393,P均＜0.05),術後1、6箇月Oswestry功能障礙指數明顯低于小切口組[12.1±4.7、18.6±3.6,5.4±2.3、13.2±2.7],差異有統計學意義(t值分彆為6.013、12.045,P均＜0.05).結論 腰椎經皮椎間孔鏡技術在手術切口、術中齣血量、術後臥床和住院時間等方麵具有明顯優越性,對脊柱穩定結構破壞小,患者術後恢複快.
목적 탐토경피추간공경수술치료요추간반돌출증적림상효과.방법 선택2012년11월지2013년11월재아원행수술치료적요추간반돌출증환자60례,기중행경추간공경치료30례,행소절구추판개창수핵적제술30례,대비분석량조환자적주원시간、술중출혈량、수술절구장도、와상시간이급술후24、48h시각모의평분,채용Oswestry공능장애지수대량조환자술후72 h화술후1、6개월적일상생활능력진행평정.결과 추간공경조재절구장도、술중출혈량、술후와상시간화주원시간방면명현우우소절구조[(0.7±0.2)、(4.9±0.2) cm,(11.6±2.2)、(102.9±16.3) ml,(27.5±8.2)、(94.1±19.7)d,(3.3±1.1)、(8.3±2.1)d],차이균유통계학의의(t치분별위81.332、30.403、17.095、.11.552,P균＜0.05),추간공경조술후24、48、72 h시각모의평분명현저우소절구조[(3.7±1.2)、(6.8독1.9)분,(2.1±1.1)、(5.3±1.6)분,(1.4±0.9)、(4.4±1.5)분],차이균유통계학의의(t치분별위7.555、9.026、9.393,P균＜0.05),술후1、6개월Oswestry공능장애지수명현저우소절구조[12.1±4.7、18.6±3.6,5.4±2.3、13.2±2.7],차이유통계학의의(t치분별위6.013、12.045,P균＜0.05).결론 요추경피추간공경기술재수술절구、술중출혈량、술후와상화주원시간등방면구유명현우월성,대척주은정결구파배소,환자술후회복쾌.
Objective To explore clinical efficacy of percutaneous tiansforaminal endoscopic discectomy on postoperative complications of patients with the protrusion of lumbar intervertebral disc.Methods Sixty cases of lumbar protrusion of the intervertebral disc were selected as our subjects from Nov.2012 to Nov.2013 who were hospitalized in the Seven People's Hospital of Zibo.Of which,30 cases were preformed lumbar protrusion of the intervertebral disc through transforaminal endoscopic treatment.Another 30 case were with small incision fenestration laminectomy discectomy.The information of hospitalized periods,bleeding volume,operation incision length and periods within the bed were collected.Visual analogue scale (VAS) was performed at postoperative 24,48 h.The Oswestry disability index (ODI) was applied to evaluated the daily life ability assessment of patients before surgery,1 month and 6 months after surgery.Results The incision length,intraoperative bleeding volume,postoperative bed and hospitalization periods in patients with transforaminal endoscopic treatment were ((0.7 ± 0.2) cm,(11.6 ± 2.2) ml,(27.5 ± 8.2) d,(3.3 ± 1.1) d respectively,less than that in patients with small incision fenestration laminectomy discectomy ((4.9 ± 0.2) cm,(102.9 ±16.3) ml,(94.1 ±19.7) d,(8.3 ±2.1) d).The differences were significant (t =81.332,30.403,17.095 and 11.552;P＜0.05).VAS in patients with transforaminal endoscopic treatment and in patients with small incision fenestration laminectomy discectomy were (3.7 ± 1.2) and (6.8 ± 1.9),(2.1 ± 1.1) and (5.3 ±1.6),(1.4 ±0.9) and (4.4 ± 1.5) respectively,and the differences were significant(t =7.555,9.026,9.393 ; P ＜ 0.05).The ODI in patients with transforaminal endoscopic treatment at 1 and 6 months after surgery were 12.1 ± 4.7 and 18.6 ± 3.6,higher than that in patients with small incision fenestration laminectomy discectomy(5.4 ± 2.3,13.2 ± 2.7),and the differences were significant (t =6.013,12.045 ; P ＜ 0.05).Conclusion Lumbar percutaneous transforaminal endoscopic discectomy is with obvious superiority than the method of small incision fenestration laminectomy discectomy in terms of the operation incision,intraoperative bleeding volume,postoperative bed and hospitalization time.Meanwhile,it shows the less damage to the spinal stability structure,and quick recovery.
