| 乐赛男,郭海艳,赵 佳,刘丽娟,蒋继乐,张 宁.经皮椎间孔镜手术不同入路治疗单节段腰椎间盘突出症疗效对比的回顾性研究[J].,2023,(3):466-470 |
| 经皮椎间孔镜手术不同入路治疗单节段腰椎间盘突出症疗效对比的回顾性研究 |
| A Retrospective Study on the Efficacy Comparison of Different Approaches of Percutaneous Foraminal Endoscopic Surgery in the Treatment of Single Segment Lumbar Disc Herniation |
| 投稿时间：2022-06-08 修订日期：2022-06-30 |
| DOI：10.13241/j.cnki.pmb.2023.03.013 |
| 中文关键词: 经皮椎间孔镜手术 经椎间孔入路 经椎板间入路 腰椎间盘突出症 疗效 |
| 英文关键词: Percutaneous foraminal endoscopic surgery Percutaneous endoscopic transforaminal discectomy Percutaneous endoscopic interlaminar discectomy Lumbar disc herniation Efficacy |
| 基金项目:首都卫生发展科研专项（2020-4-2076）；积水潭学科骨干项目（XKGG201814） |
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| 中文摘要: |
| 摘要 目的：对比经皮椎间孔镜手术不同入路治疗单节段腰椎间盘突出症（LDH）的疗效。方法：回顾性分析2018年5月至2020年5月我院收治的80例单节段LDH患者的临床资料。患者均接受经皮椎间孔镜手术，根据手术入路的不同，分为经椎间孔入路（PETD）组和经椎板间入路（PEID）组，每组均40例。比较两组的手术相关指标、术后恢复指标、手术前后的Oswestry功能障碍指数（ODI）和视觉模拟评分法（VAS）评分，以及术后并发症情况。结果：PEID组的手术时间短于PETD组，X线透视次数少于PETD组，差异均有统计学意义（P<0.05）。两组的术中出血量相比，差异无统计学意义（P>0.05）。PETD组的术后卧床时间短于PEID组，差异有统计学意义（P<0.05）。两组的术后1 d直腿抬高试验角度、住院时间、复发率相比，差异无统计学意义（P>0.05）。两组患者术后1 d、术后3个月、术后12个月的ODI评分、VAS评分均低于术前，且呈降低趋势（P<0.05）；同一时间点两组间ODI评分、VAS评分比较，差异无统计学意义（P>0.05）。两组的并发症发生率相比，差异无统计学意义（P>0.05）。结论：PETD和PEID经皮椎间孔镜手术治疗单节段LDH总体疗效和安全性接近，PETD可缩短术后卧床时间，PEID的操作难度更低、可减少手术时间和X线透视次数。临床中应视患者实际情况选择合适的入路。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the efficacy of different approaches of percutaneous foraminal endoscopic surgery in the treatment of single segment lumbar disc herniation (LDH). Methods: The clinical data of 80 patients with single segment LDH who were treated in our hospital from May 2018 to May 2020 were analyzed retrospectively. All patients underwent percutaneous foraminal endoscopic surgery, according to the different surgical approaches, the patients were divided into percutaneous endoscopic transforaminal discectomy (PETD) group and percutaneous endoscopic interlaminar discectomy (PEID) group, with 40 cases in each group. The surgery related indexes, postoperative recovery indexes, Oswestry dysfunction index (ODI) and visual analogue scale (VAS) scores before and after surgery, as well as postoperative complications were compared between the two groups. Results: The operative time of the PEID group was shorter than that of the PETD group, and the number of X-ray fluoroscopy sessions was less than that of the PETD group, the differences were statistically significant(P<0.05). Compared with the intraoperative blood loss in the two groups, there was no significant difference(P>0.05). The duration of postoperative bed rest in the PETD group was shorter than that in the PEID group, and the difference was statistically significant(P<0.05). Compared with the straight leg raise test angle, hospital stay and recurrence rate of the two groups on the first day after surgery, there was no significant difference(P>0.05). The ODI scores and VAS scores of the patients in the two groups were lower than those of before surgery at 1 d, 3 months, and 12 months after surgery, and showed a downward trend (P<0.05). Compared with the ODI score and VAS score between the two groups at the same time point, there was no significant difference(P>0.05). Compared with the incidence of complication rate between the two groups, there was no significant difference(P>0.05). Conclusion: The overall efficacy and safety of PETD and PEID percutaneous foraminal endoscopic surgery for the treatment of single segment LDH are similar, PETD can shorten the duration of postoperative bed rest, while PEID is less difficult to operate, and can reduce the operative time and the number of X-ray fluoroscopy sessions. The appropriate approach should be selected according to the actual situation of patients in clinical practice. |
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