经皮椎间孔镜腰椎间盘切除术在腰椎间盘突出症治疗中应用

目的探讨经皮椎间孔镜腰椎间盘切除术(PELD)在腰椎间盘突出症治疗中的应用价值。方法回顾性分析自2012年1月至2014年1月解放军180医院收治的90例腰椎间盘突出症患者的临床资料。将所有患者随机分为孔镜组(45例)和开窗组(45例),孔镜组行PELD,开窗组行椎板开窗腰椎间盘切除术。术后随访12个月,比较两组患者手术切口长度、手术时间、术中出血量及住院时间,并用疼痛视觉模拟(VAS)评分和改良Mac Nab标准评价疗效。结果孔镜组的切口长度、术中出血量及住院时间均小于开窗组,差异均有统计学意义(P<0.05)。术后两组患者VAS评分均有所改善,但孔镜组优于开窗组,差异有统计学意义(P<0.05)。两组术后改良Mac Nab标准评价疗效,孔镜组有效率高于开窗组,差异有统计学意义(P<0.05)。结论在腰椎间盘突出症的治疗中,应用PELD能减小手术切口,减少术中出血量,缩短住院时间,提高临床疗效,改善患者生活质量,值得临床推广。

Applicability of percutaneous endoscopic lumbar discectomy in the treatment of lumbar disc herniation

Objective To explore the clinical effect of percutaneous endoscopic lumbar discectomy( PELD) in the treatment of lumbar disc herniation. Methods 90 patients with lumbar disc herniation in our hospital from January 2012 to January 2014 were randomly divided into two groups. The observation group consisted of 45 patients were treated by PELD,while the control group received fenestra-tion discectomy. Follow-up was conducted for 12 months. Operative incision length,operation time,hemorrhage volume and hospitaliza-tion days were compared. The clinical outcome were evaluated by visual analogue score( VAS) and modified MacNab standard. Results Operative incision length,hemorrhage volume and hospitalization days in observation group was significantly less than control group (P<0. 05). The VAS score of both two groups were improved after operation. However,the improvement in observation group was sig-nificantly more obvious than control group ( P<0. 05 ) . The rate of excellence according to modified MacNab standard of observation group was significantly higher than control group(P<0. 05). Conclusion The application of PELD in the treatment of lumbar disc herniation can decrease Operative incision length,reduce hemorrhage volume,shorten operation time,improve treatment efficacy and improve patients,quality of life. It is worth of clinical promotion.