CAJ | 학술논문

目的探讨椎间孔镜下髓核摘除术治疗腰椎间盘突出症的疗效、术中穿刺路线的决策、围手术期并发症的处理及讨论一系列相关问题.方法经皮椎间孔镜下髓核摘除术,术后疗效评价内容包括:按Macnab标准、腰退痛视觉模拟评分(Visual analogue scale,VAS)及红外热成像.结果 208例患者术后随访12月,通过回顾分析,按Macnab标准评定其疗效,优182例,良23例,中3例,差0例,优良率98.6％;腰腿痛VAS评分:术后1周与术前相比差异有统计学意义(P＜0.05),术后3个月、6个月、12个月与术后1周比较差异无统计学意义(P＞0.05);红外热像提示:患者术后患肢与健肢皮温差值与术前相比差异有统计学意义(P＜0.05).结论椎间孔镜下髓核摘除术,解决症状的基础上最大限度维护患者脊柱的稳定性和灵活性.根据患者症状、体征及影像学检查,个体化设计术中穿刺路线是减少椎间孔镜围手术期并发症、提高其疗效的关键.
목적 탐토추간공경하수핵적제술치료요추간반돌출증적료효、술중천자로선적결책、위수술기병발증적처리급토론일계렬상관문제.방법 경피추간공경하수핵적제술,술후료효평개내용포괄:안Macnab표준、요퇴통시각모의평분(Visual analogue scale,VAS)급홍외열성상.결과 208례환자술후수방12월,통과회고분석,안Macnab표준평정기료효,우182례,량23례,중3례,차0례,우량솔98.6％;요퇴통VAS평분:술후1주여술전상비차이유통계학의의(P＜0.05),술후3개월、6개월、12개월여술후1주비교차이무통계학의의(P＞0.05);홍외열상제시:환자술후환지여건지피온차치여술전상비차이유통계학의의(P＜0.05).결론 추간공경하수핵적제술,해결증상적기출상최대한도유호환자척주적은정성화령활성.근거환자증상、체정급영상학검사,개체화설계술중천자로선시감소추간공경위수술기병발증、제고기료효적관건.
Objective To investigate the efficiency,decision of intra-operative puncture route,treatment of perioperative complications and discuss the other relative problems of the treament for lumbar disc herniation with percutaneous transforaminal endoscopic discectomy.Methods To excise the nucleus pulpesus under percutaneous transforaminal endoscopic discectomy,use the Macnab standard,visual analogue scale and infrared thermal imaging to estimate the efficiency.Results Among followed-up of 208 patients,182 patients were excellent and good outcome,23 patients favorable,2 patients fair,0 patient poor.The leg and back VAS was a significant improvement 1 week post-operation compared with pre-operation (P ＜ 0.05),but no statistical difference among 3 months,6 months,12 months and 1 week post-operation (P ＞ 0.05).The infrared thermal imaging point out that the legs skin temperature of D-value was a significant improvement post-operation compared with pre-operation (P ＜ 0.05).Conclusions The method excised the nucleus pulpesus,and provided the spine maximum protection about the stability and flexibility.Intra-operative puncture route of individuation design can reduce the complications of intervertebral foramen perioperative,and the key to improve the effectiveness.