经皮椎间孔镜与椎板开窗椎间盘切除术治疗腰椎间盘突出症的对比分析

林榕镔 尹金铭 林家永 吴贵洲

[摘要] 目的 對比经皮椎间孔镜与椎板开窗椎间盘切除术治疗腰椎间盘突出症的效果。 方法 方便抽样法选取2018年10月—2019年10月该院收治的68例腰椎间盘突出症患者。抽签法分组：对照组（34例）给予椎板开窗椎间盘切除术，研究组（34例）给予经皮椎间孔镜椎间盘切除术。比较两组治疗效果。 结果 研究组切口长度（1.02±0.21）cm小于对照组的（2.56±0.27）cm，术中出血量（30.25±15.65）mL少于对照组的（75.85±16.05）mL，住院时间（7.24±2.13）d短于对照组的（10.15±2.05）d，差异有统计学意义（t=26.252、11.861、9.608，P<0.05）;研究组术后1 d、3 d、1周时，VAS评分分别为（2.01±0.76）、（1.64±0.67）、（1.42±0.62）分均低于对照组的（2.35±0.72）、（2.01±0.56）、（1.77±0.54）分，差异有统计学意义（t=2.203、2.874、2.887， P<0.05）;研究组术后并发症发生率（5.88%）低于对照组（26.47%），差异有统计学意义（χ2=5.314，P=0.021<0.05）。 结论 腰椎间盘突出症治疗中应用经皮椎间孔镜手术可获得较椎板开窗椎间盘切除术更为理想的效果，可减小手术创伤，减轻患者疼痛，降低并发症发生率。

[关键词] 腰椎间盘突出症;椎板开窗椎间盘切除术;经皮椎间孔镜椎间盘切除术

[中图分类号] R687.3          [文献标识码] A          [文章编号] 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