椎板开窗与椎间孔镜治疗腰椎间盘突出症术后隐性失血比较分析

目的 比较分析椎板开窗减压髓核摘除术(fenestration discectomy,FD)与经皮椎间孔镜技术(percutaneous transforaminal endoscopic discectomy,PTED)治疗腰椎间盘突出症患者术后隐性失血情况.方法 选取2015年1月至2018年10月腰椎间盘突出症患...

Effects of fenestration discectomy and percutaneous transforaminal endoscopic discectomy on postoperative hidden blood loss in the treatment of lumbar disc herniation

Objective To explore effects of fenestration discectomy (FD) and percutaneous transforaminal endoscopic discectomy (PTED) on postoperative hidden blood loss in the treatment of lumbar disc herniation.Methods A total of 200 patients with lumbar disc herniation were enrolled from January 2015 to October 2018,including 100 patients in PD group and 100 patients in PTED group.General conditions,surgery-related indexes(operation time,estimated bleeding volume),hemoglobin (Hb) before and after surgery,and hematocrit (HCT)before and after surgery were recorded.Total blood loss and hidden blood loss were calculated according to Gross linear equation to compare the differences of postoperative hidden bleeding between the two groups.Results There were no significant differences in hospital stay between the two groups.Operation time of the PTED group (82.80±20.153 min) was longer than that of the FD group (70.50±21.009 min) (P < 0.05).Postoperative Hb levels[PTED (126.29±15.685 g / L),FD (134.22±16.046 g / L)]of the two groups were significantly lower than those preoperatively[PTED (140.20±16.004 g / L),FD (140.23±16.422 g / L)](P < 0.05).The intraoperative blood loss (127.87±67.120 ml),total blood loss (188.25±113.343 ml) and total Hb loss (13.94±8.492 g / L) of the FD group were significantly more than that of the PTED group[(5.38±0.700 ml),(83.18±45.963 ml),(5.98±3.725 g / L)](P < 0.05).No significant differences in the postoperative hidden blood loss were noted between the two groups(P > 0.05).Conclusions PTED is more minimally invasive than FD,but it can not significantly reduce postoperative hidden blood loss in the treatment of lumbar disc herniation.Careful operation and hemostasis can effectively reduce postoperative hidden blood loss.