經皮椎間孔鏡與椎板開窗椎間盤切除術治療腰椎間盤突出癥的對比分析

林榕鑌 尹金銘 林家永 吳貴洲

[摘要] 目的 對比經皮椎間孔鏡與椎板開窗椎間盤切除術治療腰椎間盤突出癥的效果。 方法 方便抽樣法選取2018年10月—2019年10月該院收治的68例腰椎間盤突出癥患者。抽簽法分組：對照組（34例）給予椎板開窗椎間盤切除術，研究組（34例）給予經皮椎間孔鏡椎間盤切除術。比較兩組治療效果。 結果 研究組切口長度（1.02±0.21）cm小于對照組的（2.56±0.27）cm，術中出血量（30.25±15.65）mL少于對照組的（75.85±16.05）mL，住院時間（7.24±2.13）d短于對照組的（10.15±2.05）d，差異有統計學意義（t=26.252、11.861、9.608，P<0.05）;研究組術后1 d、3 d、1周時，VAS評分分別為（2.01±0.76）、（1.64±0.67）、（1.42±0.62）分均低于對照組的（2.35±0.72）、（2.01±0.56）、（1.77±0.54）分，差異有統計學意義（t=2.203、2.874、2.887， P<0.05）;研究組術后并發癥發生率（5.88%）低于對照組（26.47%），差異有統計學意義（χ2=5.314，P=0.021<0.05）。 結論 腰椎間盤突出癥治療中應用經皮椎間孔鏡手術可獲得較椎板開窗椎間盤切除術更為理想的效果，可減小手術創傷，減輕患者疼痛，降低并發癥發生率。

[關鍵詞] 腰椎間盤突出癥;椎板開窗椎間盤切除術;經皮椎間孔鏡椎間盤切除術

[中圖分類號] R687.3? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2020）06（b）-0082-03

[Abstract] Objective To compare the effects of percutaneous intervertebral foramenectomy and laminectomy in the treatment of lumbar disc herniation. Methods Stratified sampling was convenient used to select 68 patients with lumbar disc herniation admitted to our hospital from October 2018 to October 2019. Lottery grouping： the control group （34 cases） received laminectomy and discectomy， and the study group （34 cases） received percutaneous intervertebral discectomy. Compare the treatment effect of the two groups. Results The incision length of the study group （1.02±0.21）cm was less than the control groups （2.56±0.27） cm， the intraoperative blood loss （30.25±15.65） mL was less than the control groups （75.85±16.05） mL， and the hospital stay （7.24±2.13）d was shorter than that of the control group （10.15±2.05）d， the differences were statistically significant （t=26.252， 11.861， 9.608， P<0.05）; the VAS scores of the study group at 1d， 3d， and 1 week after surgery were： （2.01±0.76） points， （1.64±0.67） points， （1.42±0.62） points were lower than the control group （2.35±0.72） points， （2.01±0.56） points， （1.77±0.54） points， the difference was statistical academic significance （t=2.203， 2.874， 2.887， P<0.05）; the incidence of postoperative complications （5.88%） in the study group was lower than that in the control group （26.47%）， the difference was statistically significant （χ2=5.314， P=0.021<0.05）. Conclusion The application of perforated intervertebral endoscopic surgery in the treatment of lumbar disc herniation can obtain a more ideal effect than laminectomy and discectomy， which can reduce surgical trauma， reduce pain and reduce the incidence of complications.

[Key words] Lumbar disc herniation; Laminectomy and discectomy; Percutaneous intervertebral discectomy