| 林世水,林 成,刘国铭,胡 旭,高尚君,周仕国.不同入路椎间孔镜下髓核摘除术治疗L5/S1椎间盘突出症近期疗效的对比研究[J].,2021,(7):1275-1278 |
| 不同入路椎间孔镜下髓核摘除术治疗L5/S1椎间盘突出症近期疗效的对比研究 |
| Comparative Study on Short-term Efficacy of Different Approaches of Endoscopic Discectomy for L5/S1 Disc Herniation |
| 投稿时间：2020-08-27 修订日期：2020-09-23 |
| DOI：10.13241/j.cnki.pmb.2021.07.016 |
| 中文关键词: 椎板间入路 椎间孔入路 髓核摘除术 L5/S1椎间盘突出症 近期疗效 |
| 英文关键词: Interlaminar approach Foramen approach Nucleus pulposus resection L5/S1 disc herniation Short-term efficacy |
| 基金项目:福建省卫生计生委青年科研项目（2014-1-2） |
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| 摘要 目的：对比经皮椎间孔入路椎间孔镜下髓核摘除术（PETD）、经皮椎板间入路椎间孔镜下髓核摘除术（PEID）治疗L5/S1椎间盘突出症（LDH）近期疗效。方法：选取2016年3月~2019年1月期间福建省立医院南院收治的L5/S1LDH患者60例的临床资料。根据入路方式的不同分为PETD组（n=27）和PEID组（n=33）。记录两组手术时间、X 线放射次数、术中出血量、住院天数。记录两组术后并发症发生情况。于术前、术后1周、术后6个月、术后12个月采用日本骨科学会（JOA）评分、视觉模拟评分法（VAS）评分、Oswestry 功能障碍指数（ODI）评分评价患者疼痛及功能恢复情况。根据改良 Macnab疗效评定标准计算患者术后临床效果优良率。结果：两组术中出血量、住院天数比较无差异（P>0.05），PEID组手术时间短于PETD组，X 线放射次数少于PETD组（P<0.05）。两组优良率组间比较无差异（P>0.05）。两组术后1周、术后6个月、术后12个月VAS、ODI评分均较术前降低，JOA评分均较术前升高（P<0.05），两组术后1周、术后6个月、术后12个月VAS、JOA、ODI评分组间比较差异无统计学意义（P>0.05）。两组并发症发生率对比差异无统计学意义（P>0.05）。结论： PEID、PETD治疗L5/S1LDH的疗效相当，均可较好的减轻临床症状及促进功能恢复，然而 PEID在缩短手术时间、减少X 线放射次数方面更具优势。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the short-term efficacy of percutaneous endoscopic discectomy (PETD) and percutaneous endoscopic lumbar discectomy (PEID) in the treatment of L5/S1 disc herniation (LDH). Methods: The clinical data of 60 patients with L5/S1LDH in South Hospital of Fujian Provincial Hospital from March 2016 to January 2019 were selected. According to the different approaches, they were divided into PETD group (n=27) and PEID group (n=33). The operation time, X-ray radiation times, intraoperative blood loss and hospitalization days of the two groups were recorded. The postoperative complications of the two groups were recorded. Japanese Orthopaedic Association (JOA), Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate the pain and functional recovery before operation, 1 week after operation, 6 months after operation and 12 months after operation. According to the modified Macnab evaluation standard, the excellent and good rate of postoperative clinical effect was calculated. Results: There was no significant difference in intraoperative blood loss and hospitalization days between the two groups (P>0.05). The operation time of PEID group was shorter than that of PETD group, and the X-ray radiation times was less than that of PETD group (P<0.05). There was no significant difference in the excellent and good rate between the two groups (P>0.05). The VAS and ODI scores in the two groups at 1 week, 6 months and 12 months after operation were lower than those before operation and JOA scores were higher than those before operation (P<0.05). There were no significant differences in VAS, JOA and ODI scores between the two groups at 1 week, 6 months and 12 months after operation (P>0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion: The efficacy of PEID and PETD in the treatment of L5/S1LDH is similar, which can reduce clinical symptoms and promote functional recovery. However, PEID has more advantages in shortening operation time and reducing the X-ray radiation times. |
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