不同术式经皮椎间孔镜治疗腰椎间盘突出症的疗效分析

目的:探讨不同术式经皮椎间孔镜治疗腰椎间盘突出症的疗效。方法:选取我院2013年9月~2015年7月我院收治的采用经皮椎间孔镜治疗的腰椎间盘突出症患者159例,根据不同手术方式进行分组,其中采用YESS手术的36例患者作为YESS组,采用TESSYS手术的76例患者作为TESSYS组,采用BEIS手术(即改良的TESSYS手术)的47例患者作为BEIS组。于术前、术后1天、3个月、6个月、12个月对所有患者进行视觉疼痛模拟评分(VAS)和改良的MacNab疗效评定。结果:三组的手术时间、术中出血量、住院时间比较差异有统计学意义(P0.05),BEIS组和TESSYS组的手术时间、术中出血量高于YESS组,且BEIS组手术时间、术中出血量高于TESSYS组,BEIS组的住院时间高于YESS组和TESSYS组,差异均有统计学意义(P0.05)。三组患者术后各时期VAS评分均较术前降低(P0.05),但三组间术前、术后不同时期VAS评分整体比较均无统计学差异(P0.05)。三组优良率整体比较,差异无统计学意义(P0.05)。结论:不同术式经皮椎间孔镜治疗腰椎间盘突出症的疗效相当,可以有效减轻术后患者的疼痛,但是三种术式的手术时间、术中出血量、住院时间有所差异,临床上针对不同类型的腰椎间盘突出症应采用不同术式,以获得更确切的疗效。

Curative Effect Analysis of Different Surgical Percutaneous Transforaminal Endoscopy Treatment of Lumbar Disc Herniation

ABSTRACT Objective: To investigate the curative effect of the different surgical percutaneous transforaminal endoscopy treatment of lumbar disc herniation. Methods: 159 patients with lumbar disc herniation treated by percutaneous transforaminal endoscopy from September 2013 to July 2015 in our hospital were selected, there were divided into groups according to different surgical proce- dures. Among them, group YESS were underwent YESS surgery (n=36), group TESSYS were underwent TESSYS surgery, it was modi- fied TESSYS surgery (n=76), group BEIS were underwent BEIS surgery (n=47). All patients were evaluated by the visual analogue scale (VAS) and the modified MacNab effect at preoperative, one day, three months, six months, twelve months after operation. Results: The operation time, the amount of bleeding and the length of stay in the three groups were statistically significant(P<0.05). The operation time, the amount of bleeding in the group BEIS and group TESSYS were higher than that in group YESS, and the operation time, the amount of bleeding in the group BEIS were higher than that in group TESSYS, the length of stay in group BEIS was higher than that in group YESS and group TESSYS, the differences were statistically significant(P<0.05). The scores of VAS at each postoperative period in the there groups were lower than those before operation(P<0.05), while the scores of VAS was no significant difference between the three groups in preoperative and different postoperative period(P>0.05). There was no significant difference between the three groups in the excellent rate(P>0.05). Conclusion: The curative effect of the different surgical percutaneous transforaminal endoscopy treatment of lum- bar disc herniation are therapeutic equivalence, and they can effectively alleviate the pain of the patients after operation. However, the operation time, the amount of bleeding and the length of stay in the three operation methods are different. In clinical, different surgical procedures should be used for different types of lumbar disc herniation in order to obtain more accurate results.