新冠肺炎疫情下脊柱内镜治疗腰椎间盘突出症日间手术模式及效果分析

摘要：目的　比较新冠肺炎疫情下，脊柱内镜治疗腰椎间盘突出症的日间手术模式与普通住院模式的临床疗效。方法　回顾性分析脊柱内镜治疗腰椎间盘突出症的日间手术模式和普通住院模式各50例患者资料，比较2组患者的手术时间、出血量、住院时间、住院费用。采用视觉模拟评分（VAS）、功能障碍指数（ODI）评分和改良MacNab疗效评定标准分别于术前、术后1个月对患者进行评估。结果　所有纳入的100例患者均成功完成了经皮内镜下腰椎间盘切除术（PELD）。日间手术组的住院时间与住院费用明显低于普通住院组（P＜0.05）。2组患者术后的VAS、ODI评分较术前均显著改善（P＜0.05）；2组患者术前、术后VAS和ODI评分差异无统计学意义；日间手术模式和普通住院模式患者的改良MacNab优良率分别为91.7%和92.0%（P＞0.05）。结论　在新冠肺炎疫情期间，日间手术模式下脊柱内镜手术治疗腰椎间盘突出症安全可行、切实有效，能够缩短住院时间和降低住院费用，值得推广应用。

Analysis of the effect of lumbar disc herniation treated by spinal endoscope in ambulatory surgery mode during the prevalence of COVID-19

Abstract: Objective　To compare the clinical efficacy between lumbar disc herniation treated by spinal endoscope in ambulatory surgery mode and general hospitalization mode during the prevalence of the COVID-19. Methods　The 100 patients with lumbar disc herniation treated by percutaneous endoscopic lumbar discectomy (PELD) with ambulatory surgery mode or general hospitalization mode were analyzed retrospectively. The operation time, blood loss, hospitalization time and hospitalization cost were compared between the two groups. Visual analogue scale (VAS), Oswestry disability index (ODI) and modified MacNab criteria were performed before surgery and 1 month after surgery in the two groups of patients. Results　All the patients completed PELD surgery successfully. The hospitalization time and hospitalization cost were significantly lower in the ambulatory surgery mode than those of the general hospitalization mode (P＜0.05). The VAS and ODI scores were significantly improved after operation compared with those before operation in the two groups (P＜0.05). There were no significant differences in the VAS and ODI scores before and after the operation between the two groups of patients. The excellent and good rates of modified MacNab in the ambulatory surgery mode and general hospitalization mode were 91.7% and 92.0% respectively, and there was no significant difference between them (P＞0.05). Conclusion　During the prevalence of the COVID-19, PELD in ambulatory surgery mode is safe, feasible and effective. It can reduce the hospitalization time and hospitalization cost, which is worthy of popularization and application.