CAJ | 학술논문

目的：比较椎间孔镜下髓核摘除术（percutaneous transforaminal endoscopic discectomy，PTED）与小切口髓核摘除术治疗腰椎间盘突出症的临床疗效。方法选取本院2012年1月至2013年6月收治的腰椎间盘突出症患者96例，随机分为2组。椎间孔镜组48例，其中男性28例，女性20例；年龄22~57岁，平均（42.80±10.32）岁。小切口组48例，其中男性26例，女性22例；年龄27~69岁，平均（47.20±11.29）岁。比较患者的手术时间、术中出血量、术后下地时间、平均住院时间、Oswestry 功能障碍指数（oswestry disability index，ODI）、VAS 评分（visual analogue scale， VAS）、日本骨科协会（ Japanese orthopaedic association，JOA）评分。结果椎间孔镜组和小切口组手术时间分别为（62.01±7.54）min 和（75.35±10.25）min，术中出血量为（20.35±6.99）mL 和（65.50±13.55）mL，手术切口大小为（1.25±0.30）cm 和（5.50±1.55）cm，术后1年 JOA 评分为（22.75±4.25）分和（23.45±3.91）分。PTED 组的术中手术时间、出血量、平均住院时间及下地时间少于小切口组（P <0.05）。两组患者手术前后的 JOA 值、VAS 评分和ODI 值差异均无统计学意义（P >0.05）。结论与小切口髓核摘除术相比，经皮椎间孔镜技术治疗椎间盘突出症疗效确切，且具有创伤小、恢复快等优点，是一项有效的治疗手段。
목적：비교추간공경하수핵적제술（percutaneous transforaminal endoscopic discectomy，PTED）여소절구수핵적제술치료요추간반돌출증적림상료효。방법선취본원2012년1월지2013년6월수치적요추간반돌출증환자96례，수궤분위2조。추간공경조48례，기중남성28례，녀성20례；년령22~57세，평균（42.80±10.32）세。소절구조48례，기중남성26례，녀성22례；년령27~69세，평균（47.20±11.29）세。비교환자적수술시간、술중출혈량、술후하지시간、평균주원시간、Oswestry 공능장애지수（oswestry disability index，ODI）、VAS 평분（visual analogue scale， VAS）、일본골과협회（ Japanese orthopaedic association，JOA）평분。결과추간공경조화소절구조수술시간분별위（62.01±7.54）min 화（75.35±10.25）min，술중출혈량위（20.35±6.99）mL 화（65.50±13.55）mL，수술절구대소위（1.25±0.30）cm 화（5.50±1.55）cm，술후1년 JOA 평분위（22.75±4.25）분화（23.45±3.91）분。PTED 조적술중수술시간、출혈량、평균주원시간급하지시간소우소절구조（P <0.05）。량조환자수술전후적 JOA 치、VAS 평분화ODI 치차이균무통계학의의（P >0.05）。결론여소절구수핵적제술상비，경피추간공경기술치료추간반돌출증료효학절，차구유창상소、회복쾌등우점，시일항유효적치료수단。
Objective To explore and compare the efficacy of percutaneous transforaminal endoscopic discectomy(PTED) and small incision method on lumbar disc herniation. Methods 96 patients with lumbar disc herniation were randomly divided into PTED group and small incision method group(each n = 48). The operating time,hemorrhage,ambulation and average hos-pitalization time,Oswestry disability index(ODI),visual analogue scale(VAS)and Japanese orthopedics association(JOA) between the groups were compared. Results The operation time of PTED and small incision method were 62. 01 ± 7. 54 and 75. 35 ± 10. 25(min),hemorrhage were 20. 35 ± 6. 99 and(65. 50 ± 13. 55)mL,incision size were 1. 25 ± 0. 30 and(5. 50 ± 1. 55)cm,visual analogue scale(VAS)were 22. 75 ± 4. 25 and 23. 45 ± 3. 91(point). The operation time,hemorrhage,ambu-lation and average hospitalization time in PTED group were less than those in small incision method group.(P < 0. 05). There were no significant differences in JOA,VAS and ODI between the two groups before or after the operation(P > 0. 05). Con-clusion Compared with open lumbar disectomy,percutaneous transforaminal lumbar spinal endoscopic technique is an effec-tive treatment for lumbar disc herniation,with the advantages of less trauma and bleeding,rapid recovery and fewer complica-tion.