1.浙江省人民医院淳安分院 骨科,浙江 杭州 311700;2.浙江省人民医院 骨科,浙江 杭州 314000
1.Department of Orthopedics, Chun’an Branch, Zhejiang Provincial People’s Hospital, Hangzhou, Zhejiang 311700, China;2.Department of Orthopedics, Zhejiang Provincial People’s Hospital, Hangzhou, Zhejiang 314000, China
目的 对比分析经皮椎间孔镜技术与显微镜辅助治疗腰椎间盘突出症的临床效果。方法 采用随机数表法，将2017年10月－2019年12月该院收治的60例腰椎间盘突出症患者随机分为：采用经皮椎间孔镜治疗的试验组和采用显微镜辅助治疗的对照组，每组30例。术后分析两组患者的临床治疗效果。结果 试验组手术时间和住院时间均短于对照组，切口长度短于对照组，术中出血量少于对照组（P < 0.05）；术后1周，试验组视觉模拟评分（VAS）低于对照组，日本骨科学会（JOA）评分高于对照组（P < 0.05）；两组患者临床优良率、术后1和3个月VAS和JOA评分比较，差异均无统计学意义（P > 0.05）；对照组术中发生1例硬膜囊撕裂，采用可吸收线修补。其余患者术中及术后均无并发症发生。结论 经皮椎间孔镜技术可有效缩小手术切口，减少术中失血量，减轻短期疼痛，促进患者腰椎功能恢复，且不增加患者并发症发生率，值得临床推广应用。
Objective To compare and analyze the clinical effect of percutaneous transforaminal endoscopic technique and microscope-assisted treatment of lumbar disc herniation.Methods 60 patients with lumbar disc herniation from October 2017 to December 2019 were randomly divided into the experimental group treated with percutaneous transforaminal endoscopy and the control group treated with microscope-assisted treatment, there were 30 cases in each group. Analyzed the clinical treatment effects.Results The time of surgery and the hospitalization time of the experimental group were shorter than those of the control group, the incisive length of the experimental group was shorter than that of the control group, and intraoperative blood loss was less than that of the control group (P < 0.05). At 1 week after operation, the visual analogue scale (VAS) of experimental group was lower than that of the control group, the Japanese Orthopaedic Association (JOA) score of experimental group was higher than that of the control group (P < 0.05); There were no significant differences in clinical excellent rate, the VAS and the JOA score at 1 and 3 months after operation between the groups (P > 0.05). There was 1 case of dural sac tear in the control group during the operation, repaired with absorbable suture. No intraoperative and postoperative complications occurred in the remaining patients.Conclusion Percutaneous transforaminal endoscopic technique of lumbar disc herniation can effectively shorten the surgical incision, reduce the blood loss during the operation, and can effectively reduce the pain of the patient in the short term after the operation, promote the recovery of the lumbar spine function of the patient, and can not increase the occurrence of adverse complications in the patient, it is worthy of clinical application.