MED与APLD两种方法治疗腰椎间盘突出症的临床疗效比较

目的比较后路显微内镜椎间盘切除术（MED）与自动经皮腰椎间盘切吸术（APLD）治疗腰椎间盘突出症的临床疗效。方法根据患者病情，按照资料方法将320例患者分为MED组和APLD组，并采取相应的治疗方法。比较两组手术时间、术中出血量、住院天数和临床疗效。结果MED组和APLD组在手术时间、术中出血量、住院天数相比，差异无统计学意义（P〉0．05）。MED组和APLD组治疗优良率分别为90．63％和90．99％，差异无统计学意义（X^2=1．077，P〉0．05）。两组各有1例发生椎间盘炎，对症治疗后康复。患者整体恢复情况良好，均未出现术后复发再手术病、发生神经根损伤、术中大出血病例。结论MED和APLD作为治疗腰椎间盘突出症的手术方法，在严格掌握手术适应证的情况下，疗效并没有明显差异。在临床实践中，务必要根据患者手术指证，选择合适的方法，获得更好的治疗效果。

Comparison of the Clinical Efficacy Between MED and APLD in the Treatment of Lumbar Disc Herniation

Objective To compare the clinical efficacy between posterior microendoscopic discectomy（MED）and automated percutaneous lumbar discectomy （APLD） in the treatment of lumbar disc herniation.Methods 320 cases of patients were divided into MED group and APLD group according to the patient＇ s condition and data method,and they were given appropriate treatment, respectively. The duration of operation, intraoperative blood loss,hospital day and clinical efficacy of two groups were compared. Results There were no statistically significant differences between MED group and APLD group in the duration of operation, intraoperative blood loss, hospital day, the difference was not statistically significant（P〉0.05）. The excellent and good rate of MED group and APLD group was 90.63% and 90.99%, respectively,there was no statistically significant difference between the two groups in efficacy（ X 2=1.077,P〉0.05,）. Both groups had 1 case of discitis, and the patient recovered after symptomatic treatment. All the patients recovered well, no postoperative recurrence, nerve root injury,intraoperative bleeding cases occurred.Conclusion As the surgical treatment method for lumbar disc herniation, there is no significant difference in the clinical efficacy between MED and APLD on the basis of mastering the surgical indications strictly. In order to obtain better treatment effect,it is necessary to select appropriate method according to the patient＇ s surgical indications.