椎间盘镜下髓核切除术和经皮穿刺椎间孔镜下髓核切除术治疗腰椎间盘突出症的手术效果分析

发布时间：2018-03-31 07:04

本文选题：腰椎间盘突出症　切入点：椎间盘镜下髓核摘除术　出处：《东南大学》2015年硕士论文

【摘要】：背景：椎间盘镜下髓核切除术(MED)和经皮穿刺椎间孔镜下髓核切除术(PTED)是治疗腰椎间盘突出症的微创外科手术技术,现有的研宄证实二者都是安全有效的手术方式。目的：比较MED和PTED治疗腰椎间盘突出症的安全性及临床疗效。方法：回顾性分析在中大医院接受微创椎间盘摘除手术患者的临床疗效,其中MED手术50例,PTED手术36例。对所有的患者进行随访,随访时间1年。使用自我评价问卷,the Oswestry Disability Index (ODI), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36)和MacNab criteria进行临床疗效评价。结果用SPSS20.0软件进行分析,P0.05有统计学意义。结果：两组患者在年龄、性别、主要症状及体征上无明显差异。两组患者术前的ODI评分无统计学差异(53.00 v.s 48.72,p=0.112)。术后一年随访期内,MED组的ODI评分平均为4.96,PTED组为3.61。MacNab评分MED组92.0%的患者临床疗效达到良好及以上,PTED组94.4%的患者临床疗效达到良好及以上,两组间无统计学差异(P=D.001)。平均手术时间PTED组更长,平均手术费用PTED组更高(P0.001)。平均失血量MED组更多(P0.001)。平均住院时间两组间无差异(p0.255)。两组患者均未出现并发症。结论：MED和PTED在治疗椎间盘突出症的安全性及短期临床疗效上无显著差异。
[Abstract]:Background: MED and PTED are minimally invasive surgical techniques for the treatment of lumbar disc herniation. Objective: to compare the safety and clinical efficacy of MED and PTED in the treatment of lumbar disc herniation. Clinical efficacy of patients undergoing surgery, There were 50 cases of MED operation and 36 cases of MED operation. All the patients were followed up. All patients were followed up for 1 year. The clinical efficacy was evaluated with Medical Outcomes Study 36-Item Short-Form Health Survey 36 (Medical Outcomes Study 36-Item Short-Form Health Survey SF-36) and MacNab criteria. Results: there were significant differences between the two groups in age, sex, and age. There was no significant difference in the main symptoms and signs between the two groups. There was no significant difference in preoperative ODI score between the two groups. The ODI score of Med group was 4.96% and 3.61.MacNab score was 92.0% of the patients in MED group. And more than 94. 4 percent of the patients in the PTED group have good clinical outcomes and above. There was no statistical difference between the two groups. The mean operation time in PTED group was longer than that in PTED group. The average cost of operation in PTED group was higher than that in PTED group. The average blood loss in MED group was higher than that in MED group. There was no difference in average hospitalization time between the two groups (p 0.255). There were no complications in both groups. Conclusion the safety of PTED and PTED in the treatment of intervertebral disc herniation and short-term clinical treatment are not significant. There was no significant difference in effect.
【学位授予单位】：东南大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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