椎间孔镜腰椎间盘切除术与胶原酶髓核溶解术治疗单节腰椎间盘突出症的比较

目的 比较椎间孔镜腰椎间盘切除术(PTED)与胶原酶髓核溶解术治疗单节腰椎间盘突出症的临床疗效.方法 将本院2015年2月至2016年2月收治的78例单节腰椎间盘突出症患者随机分为两组,各39例.对照组应用胶原酶髓核溶解术治疗,观察组采用PTED治疗.比较两组手术疗效及术后疼痛情况.结果 两组手术优良率相近(92.31％比87.18％),差异无统计学意义(P＞0.05);观察组术后1月、3月及6月疼痛评分各为(2.16±1.04)分、(1.84±0.38)分、(1.43±0.25)分,均明显低于对照组的(3.97±1.28)分、(2.68±0.42)分、(1.82±0.31)分,两组比较差异均有统计学意义(均P＜ 0.05).结论 PTED与胶原酶髓核溶解术均可有效治疗单节腰椎间盘突出症,但在短期疗效方面,PTED较胶原酶髓核溶解术可明显减轻术后疼痛.

Comparison of the treatment of lumbar intervertebral disc herniation with lumbar discectomy and collagenase

Objective To compare the clinical efficacy of endoscopic lumbar discectomy (PTED) and collagenase in the treatment of lumbar disc herniation.Methods 78 cases of lumbar disc herniation treated in our hospital from February 2015 to February 2016 were randomly divided into two groups,39 cases in each group.The control group was treated with collagenase,while the observation group was treated with PTED.The operation effect and postoperative pain were compared between the two groups.Results The excellent rate of the operation of two groups were similar (92.31％ vs.87.18％),without statistically significant difference (P＞0.05).The pain scores of the observation group 1,3,6 months after operation were (2.16± 1.04),(1.84±0.38),(1.43±0.25),significantly lower than those of the control group [(3.97±1.28),(2.68±0.42),(1.82±0.31)],with statistically significant differences (P＜0.05).Conclusion PTED and collagenase both can effectively treat lumbar intervertebral disc herniation,but in short term efficacy,PTED can significantly reduce postoperative pain compared with collagenase nucleus pulposus dissolution.