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目的：探讨椎间孔镜技术治疗腰椎间盘突出症的临床疗效及对患者预后的影响。方法：选择2012 年9 月-2014 年9 月在我院接受手术治疗的腰椎间盘突出症患者93 例作为研究对象，根据手术方法不同，将所选研究对象分为椎间孔镜组（47 例）和腰椎间盘切除组（46 例）。椎间孔镜组患者采用经皮椎间孔镜手术治疗，腰椎间盘切除组患者采用显微内镜下后路腰椎间盘切除术治疗。观察并比较两组患者的手术时间、术中出血量、切口长度以及住院时间等，分别于手术前后采用主诉疼痛分级法（VRS）和视觉模拟法（VAS）评价临床疗效。结果：椎间孔镜组患者手术时间为（63.54± 12.28）min、术中出血量为（10.39± 2.91）mL、切口长度为（0.84± 0.13）cm、住院时间为（6.25± 1.48）d；腰椎间盘切除组患者手术时间为（58.82± 10.47）min、术中出血量为（81.56± 20.48） mL、切口长度为（1.92± 0.35）cm、住院时间为（9.94± 1.65）d；与腰椎间盘切除组比较，椎间孔镜组患者手术时间长、术中出血量少、手术切口小、住院时间短，差异均具有统计学意义（P＜0.05）。两组术后VRS及VAS评分均显著低于术前，差异具有统计学意义（P＜0.05）；椎间孔镜组术后VRS 及VAS 评分均显著低于腰椎间盘切除组，差异均具有统计学意义（P＜0.05）。椎间孔镜组患者手术优良率（72.34%）显著高于腰椎间盘切除组（56.52%），差异具有统计学意义（P<0.05）。结论：经皮椎间孔镜技术治疗腰椎间盘突出症的临床效果显著，不仅能够改善患者关节疼痛症状，而且手术对患者机体创伤小，有利于术后恢复。

英文摘要:

Objective:To investigate the clinical effect of PELD on the treatment of lumbar disc herniation and its effect on the prognosis of patients.Methods:93 cases with disc herniation who were treated with surgery in our hospital from September 2012 to September 2014 were selected as the research objects, and according to the different operation methods, the patients were divided into the PELD group (47 cases) and the MED group (46 cases). The patients in the PELD group were treated with percutaneous lumbar disc surgery, while the patients in the MED group were treated with microsurgical endoscopic discectomy. Then the operation time, blood loss, incision length and hospitalization in the two groups were observed and compared. And the verbal rating scale (VRS) and visual analogue score (VAS) were used to evaluate the clinical curative effect.Results:The operation time in the PELD group was (63.54± 12.28) min, which was longer than (58.82± 10.47) min in the control group, and the difference was statistically significant (P<0.05); The blood loss in the PELD group was (0.39± 2.91) mL, which was lower than (81.56± 20.48) mL n the control group, and the difference was statistically significant (P<0.05); The incision length in the PELD group was (0.84± 0.13) cm, which was larger than (1.92± 0.35) cmin the control group, and the difference was statistically significant (P<0.05); The hospitalization in the PELD group was (6.25± 1.48) day, which was longer than (9.94± 1.65) day in the control group, and the difference was statistically significant (P<0.05). After the surgery, the VRS and VAS in the two groups were lower than before, and the PELD group was lower than that of the MED group, and the differences were statistically significant (P<0.05); The excellent and good rate in the PELD group was 72.34%, which was higher than 56.52%of the MED group, and the difference was statistically significant (P<0.05).Conclusion:Percutaneous transforaminal endoscopic discectomy can significantly improve the pain symptoms in patients with prolapse intervertebral lumbar disc with small incision, which is conducive to postoperative recovery.

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