传统手术与微创治疗腰椎间盘突出症的疗效比较

目的比较开放型椎间盘切除术与微创椎间盘切除术治疗腰椎间盘突出症的效果。方法选择腰椎间盘突出症(LDH)伴有明显腰痛的患者100例,随机分为开放型椎间盘切除术组(OD组)和微创椎间盘切除术组(MD组)各50例。手术前后进行简明健康调查表(SF-36)、Oswestry功能障碍指数(ODI)和视觉模拟评分(VAS),对患者满意度以及恢复工作状态进行调查,比较2组之间治疗效果。结果与术前相比,2组患者手术后症状均有改善。SF-36中的PHC、MHC和Oswestry评分、VAS评分较手术前明显改善,差异有统计学意义(P<0.05),但OD组与MD组差异无统计学意义(P>0.05)。OD组和MD组患者术后总体满意度、疼痛复发率和恢复工作率分别为34.0%、10.0%、68.0%和46.0%、8.0%、60.0%,2组比较差异无统计学意义(P>0.05)。结论 OD、MD 2种手术方式均能够显著改善腰椎间盘突出症患者术后生活质量,虽然MD术后恢复较快,并发症发生率低,但与OD手术相比无明显差别。

Analysis of traditional surgery and minimally invasive treatment of lumbar disc herniation

Objective To compare the open discectomy and minimally invasive discectomy treatment effect.Methods Lumbar disc herniation（LDH） patients（n =100） with obvious low back pain,divided into 2 groups randomly,respectively received OD（open discectomy operation） or MD operation（minimally invasive discectomy）,each group has 50 cases. Before and after surgery,health related quality of life survey（SF-36）,Oswestry disability index（ODI） survey and VAS scores,patient satisfaction and return to work status were investigate for the treatment effects between the two groups were compared. Results Quantitative analysis showed that all questionnaire,symptoms were improved in patients after operation compared to patients before operation.The PHC and MHC group in SF-36,Oswestry score and VAS score were statistically different between the results before and after operation（P 0.05）,but the difference was not statistically significant between OD group and MD group（P 0.05）.Patients overall satisfaction,pain recurrence rate and recovery rate were 34.0%,10.0%, 68.0%and 46.0%,8.0%,60.0%respectively in the two groups.But by two kinds of operation modes（MD and OD） in the patients with postoperative has no significant statistical difference（P 0.05）.Conclusion Both the 2 kinds of operations can significantly improve the quality of life of patients,although minimally invasive discectomy has rapid postoperative recovery,can reduce the incidence of complications,but it was no significant difference compared with open discectomy surgery.