| 宋永平,韩 亮,铁 钊,李强松,李 强.椎间孔镜与开窗术对腰椎间盘突出患者远期治疗效果对比[J].,2020,(18):3490-3493 |
| 椎间孔镜与开窗术对腰椎间盘突出患者远期治疗效果对比 |
| The Comparison of Long-term Treatment of Lumbar Disc Herniation with Intervertebral Foramen and Fenestration |
| 投稿时间：2019-12-27 修订日期：2020-01-23 |
| DOI：10.13241/j.cnki.pmb.2020.18.020 |
| 中文关键词: 椎间孔镜 开窗术 腰椎间盘突出 远期治疗效果 |
| 英文关键词: Foraminoscopy Fenestration Lumbar disc herniation Long-term therapeutic effect |
| 基金项目:国家自然科学基金项目（81772411） |
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| 中文摘要: |
| 摘要 目的：探究椎间孔镜与开窗术对腰椎间盘突出患者治疗远期效果对比。方法：选择2016年3月至2018年3月于我院接受治疗的腰椎间盘突出患者，按照其接受术式的不同将其分为孔镜组（108例）和开窗组（40例），对比两组手术出血量、术后卧床时间及切口长度，对比两组术前、术后3个月及术后12个月腰椎日本矫形外科学会(Japan Orthopaedic Assoctiation，JOA)评分、Odwestry功能障碍指数（Odwestris ability index, ODI）评分、视觉模拟评分（Visual analog scales，VAS）及生活质量评分，最后对比两组术后12个月椎间隙高度降低数值。结果：（1）孔镜组术中出血量、术后卧床时间及切口长度均小于开窗组，手术时间长于开窗组（P<0.05）；（2）术前两者JOA及ODI评分对比无统计学意义（P>0.05），术后3个月及术后12个月孔镜组JOA及ODI评分优于开窗组（P<0.05）；（3）术前两组VAS及SF-36量表(the 36-item shot form health survey，SF-36)评分对比无统计学意义（P>0.05），术后3个月及12个月两组VAS评分均有明显下降，SF-36评分有明显上升（P<0.05），且术后3个月及12个月孔镜组SF-36评分高于开窗组（P<0.05），VAS评分对比无统计学意义（P>0.05）；（4）术后12个月，孔镜组椎间隙高度降低率低于开窗组（P<0.05）。结论：椎间孔镜在治疗腰椎间盘突出方面效果较好，相比于开窗术，孔镜术患者术中创伤小、术后恢复快、腰椎功能改善明显，且远期随访显示患者生活质量更高，值得进行临床推广。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the long-term effect of foraminoscopy and fenestration in the treatment of patients with lumbar disc herniation. Methods: The patients with lumbar intervertebral disc herniation treated in our hospital from March 2016 to March 2018 were selected as the research objects. They were divided into two groups according to the different surgical methods: the foramen group (108 cases) and the fenestration group (40 cases). The amount of bleeding during operation, the time of bed rest and the length of incision after operation were compared between the two groups. JOA, Odwestry disability index (ODI), visual analogue scale (VAS) and quality of life scores of the lumbar spine 12 months after operation were compared. Finally, the intervertebral height of the two groups was decreased 12 months after operation. Results: (1) The amount of bleeding during operation, the time of bed rest and the length of incision after operation were less than those in the fenestration group, and the operation time was longer than that in the fenestration group (P<0.05). (2) There was no significant difference in JOA and ODI scores between the two groups before operation (P>0.05). There was no significant difference between the two groups at 3 months and 12 months after operation (P> 0.05). The JOA and ODI scores of the patients were better than those of the fenestration group (P<0.05). (3) There was no significant difference in VAS and SF-36 scores between the two groups before operation (P>0.05). The SF-36 scores of the three and 12 months after operation were higher than those of the fenestration group (P<0.05). There was no significant difference in VAS scores between the two groups (P>0.05). (4) There was no significant difference in the scores of the 36-item shot form health survey (SF-36) between the two groups (P>0.05). The VAS scores of the two groups were 3 months and 12 months after operation. There was a significant decrease in SF-36 scores (P<0.05), and the SF-36 scores in the ocular group were higher than those in the fenestration group at 3 and 12 months after surgery (P<0.05). Statistical significance (P>0.05). Conclusion: Intervertebral foramen endoscopy has a better effect in the treatment of lumbar disc herniation. Compared with fenestration, the operation has less trauma, faster recovery and better lumbar function. The long-term follow-up shows that the quality of life of patients is higher, which is worthy of clinical promotion. |
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