经皮椎间孔镜髓核摘除术治疗髓核脱出型腰椎间盘突出症的疗效分析.docVIP

精品论文 参考文献 经皮椎间孔镜髓核摘除术治疗髓核脱出型腰椎间盘突出症的疗效分析 1湖北医药学院附属东风总医院 442000；2湖北省孝感市云梦县人民医院 432500 【摘 要】目的 对髓核脱出型腰椎间盘突出症患者采用经皮椎间孔镜髓核摘除术治疗并分析其疗效。方法 利用经皮椎间孔镜髓核摘除术治疗31例（男17例，女14例）髓核脱出型腰椎间盘突出症患者，年龄32—65岁，平均48.6plusmn;plusmn;2.3岁，病程6个月—5年，平均11plusmn;3.3个月，其中L4-L5突出19例，L5-S1突出5例，L4-L5合并L5-S1突出7例。术后所有患者均获3个月随访，手术疗效通过视觉模拟评分（VAS）法评定。结果 所有患者均顺利完成手术，手术时间50—110min，平均70min，术中出血20—100ml，术后住院时间3—7d，平均5.3天。术后患者症状改善明显，无并发症发生，术前VAS评分（7.23plusmn;0.60），术后第一天VAS评分（0.90plusmn;0.25），术后第三天（1.05plusmn;0.52），术后一周（1.13plusmn;0.60），术后三个月（0.95plusmn;0.70）。术后VAS评分较术前均明显降低（Plt;0.01）。结论 经皮椎间孔镜髓核摘除术具有创伤小，恢复快，并发症少等优点，对髓核脱出型腰椎间盘突出症具有明显疗效。 【关键词】腰椎间盘突出症；椎间孔镜；椎间盘切除；微创手术 【Abstract】 Objective：to explore the effects of percutaneous transforaminal endoscopic discectomy on lumbar disc herniation.Methods：Thirty-one patients with LDH were treated with percutaneous transforaminal endoscopic discectomy.Of 17 cases of male，14 cases of female，the age of 32- 65 years old，average 48.6 plusmn; 2.3 years of age，course of 6 months to 5 years，an average of 11plusmn; 3.3 months，the L4 - L5 prominent 19 cases，L5- S1 highlight in 5 cases，L4，-L5 merger L5- S1 7 cases.Postoperative follow-up of 3 months and the curative effect was evaluated by visual analog scale（VAS）.Results：All the operation were successfully completed.Surgery time 50-110 min，the average of 70min，intraoperative bleeding 20-100 ml，postoperative hospital stay 3-7 d，an average of 5.3 days.Postoperative symptoms improved significantly，no complications occurred.VAS scores were 7.23plusmn;0.60，0.90plusmn;0.25，1.05plusmn;0.52，1.13plusmn;0.60 and 0.95plusmn;0.70 before and 1day，3 days，1 week and 3 months after operation，respectively.Preoperative and postoperative scores differed significantly（all Plt;0.01）.Conclusion：percutaneous transforaminal endoscopic discectomy was an effective treatment for lumbar disc herniation，with the advantages of less trauma and bleeding，rapid recovery and fewer complication.Therefore，it is an ideal minimally invasive surgery for LDH.