| 时 强,程银树,武 进,凌 嵘,于 振.间孔镜下髓核摘除术对腰椎间盘突出患者CK、CRP及腰椎功能恢复的影响[J].,2021,(3):580-584 |
| 间孔镜下髓核摘除术对腰椎间盘突出患者CK、CRP及腰椎功能恢复的影响 |
| Effect of Nucleus Pulposus Excision Under Foramina Lens on CK, CRP and Lumbar Functional Recovery in Patients with Lumbar Disc Herniation |
| 投稿时间：2020-06-23 修订日期：2020-07-17 |
| DOI：10.13241/j.cnki.pmb.2021.03.039 |
| 中文关键词: 椎间孔镜下髓核摘除术 腰椎间盘突出 肌酸激酶 C反应蛋白 腰椎功能 |
| 英文关键词: Excision of nucleus pulposus under foramina lens Lumbar disc herniation Creatine kinase C-reactive protein Lumbar function |
| 基金项目:安徽省医药卫生科技计划项目(2019 BG0715) |
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| 中文摘要: |
| 摘要 目的：探讨椎间孔镜下髓核摘除术对椎间盘突出患者肌酸激酶（CK）、C反应蛋白（CRP）及腰椎功能恢复的影响。方法：选择2016年10月-2018年8月在我院接受治疗的90例腰椎间盘突出患者，采用抽签法分为椎间孔镜组（n=45）和后路切开组（n=45）。对照组给予后路切开髓核摘除手术治疗，观察组给予椎间孔镜下髓核摘除治疗。比较两组患者的手术情况、CK、CRP、腰椎功能、视觉模拟（VAS）评分、Oswestry 功能障碍指数（ODI）评分变化情况及并发症发生情况。结果：椎间孔镜组手术时间较后路切开组更长，术中出血量、术后下床时间及住院时间较后路切开组更低（P<0.05）；手术前，两组CK、CRP检测结果无差异；手术后，两组CK、CRP均随着时间的延长均呈上升趋势，且椎间孔镜组上升较后路切开组低（P<0.05）；手术前，两组腰椎功能检测结果无差异；手术后，两组腰椎曲度、直腿抬高试验均随着时间的延长均呈上升趋势，且椎间孔镜组上升更为明显（P<0.05）；手术前，两组VAS、ODI评分评定结果无差异；手术后，两组VAS、ODI评分均随着时间的推移均呈下降趋势，且椎间孔镜组下降更为明显（P<0.05）；手术后，与后路切开组24.44%(11/45)进行比较，椎间孔镜组4.44%(2/45)显著降低(P<0.05)。结论：在腰椎间盘突出症患者中应用椎间孔镜下髓核摘除效果显著，可有效改善CK、CRP及腰椎功能水平。 |
| 英文摘要: |
| ABSTRACT Objective: To study Effect of nucleus pulposus excision under foramina lens on Creatine kinase (CK), C-reactive protein (CRP) and lumbar functional recovery in patients with lumbar disc herniation. Methods: 90 patients with lumbar disc herniation who were treated in our hospital from October 2016 to August 2018 were selected and divided into intervertebral foramina group (n=45) and posterior incision group (n=45) by lottery. The control group was treated with posterior incision and nucleus pulposus resection, while the observation group was treated with intervertebral foramen. The changes of surgical conditions, CK, CRP, lumbar function, visual analogue scale (VAS) score, Oswestry disability index (ODI) score and complications were compared between the two groups. Results: The operative time of the foramina group was longer than that of the posterior incision group, and the amount of intraoperative blood loss, postoperative time to the ground and hospital stay were lower than that of the posterior incision group (P<0.05). Before surgery, there was no difference in CK and CRP detection results between the two groups. After surgery, CK and CRP in both groups showed an upward trend with time, and the increase in the intervertebral foramina group was lower than that in the posterior incision group (P<0.05). Before operation, there was no difference between the two groups. After surgery, the lumbar curvature and straight leg elevation tests in both groups showed an increasing trend over time, and the increase was more obvious in the foraminal lens group (P<0.05). There was no difference in VAS and ODI scores between the two groups before surgery. After surgery, VAS and ODI scores in both groups showed a downward trend with the passage of time, and the decline was more obvious in the foraminal lens group (P<0.05). After surgery, compared with the posterior incision group (24.44%(11/45), the intervertebral foramina group (4.44%(2/45) was significantly reduced (P<0.05). Conclusion: In patients with lumbar disc herniation, the effect of nucleus pulposus removal under intervertebral foramen microscopy is significant, which can effectively improve CK, CRP and lumbar function level. |
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