椎间盘镜髓核摘除术与开放髓核摘除术治疗腰椎间盘突出症的对比分析

发布时间：2018-04-27 23:01

本文选题：椎间盘镜 + 开放髓核摘除术　；参考：《福建医科大学》2015年硕士论文

【摘要】：[目的]比较椎间盘镜髓核摘除术(MED)与开放椎板开窗髓核摘除术(OD)治疗腰椎间盘突出症的优缺点以及临床疗效。[方法]分析2012年3月到2014年5月福建医科大学附属协和医院骨科收治的48例腰椎间盘突出症患者的病例资料,其中行椎间盘镜下髓核摘除术治疗者25例,行开放椎板开窗髓核摘除术者23例。使用统计学方法比较两组手术时间、术中出血量、切口长度、术后住院时间、术后并发症发生率,并运用Macnab腰椎功能评定标准评估两组术后一年疗效。[结果]两组患者年龄、性别、病变节段及病程对比无显著性差异(P0.05),两组样本具有可比性。MED组术中出血量31.72±77.34ml、切口长度2.02±0.20cm、术后住院时间7.04±1.47天,OD组术中出血量107.61±160.03ml、切口长度4.83±1.11cm、术后住院时间8.21±1.63天,MED组术中出血量、切口长度及术后住院时间显著小于OD组(P0.05),而MED组手术时间109.57±26.24min,OD组手术时间77.50±36.68min,前者手术时间显著长于后者(P0.05)。MED组术后一年疗效优病例数19例、良4例、可2例、无疗效差病例,优良率为92.00%,OD组术后一年疗效优病例数15例、良6例、可1例、差1例,优良率为91.30%,MED组出现1例并发症,并发症发生率4%。OD组出现3例并发症,并发症发生率13.04%。两组疗效优良率及并发症发生率均无统计学差异(P0.05)。[结论]椎间盘镜髓核摘除术创伤小,术后恢复快,但开展早期手术时间长于开放手术。椎间盘镜髓核摘除术治疗腰椎间盘突出症具有较佳疗效及安全性,与开放椎板开窗髓核摘除术相当。
[Abstract]:[objective] to compare the advantages and disadvantages of MED and ODD in the treatment of lumbar disc herniation. [methods] from March 2012 to May 2014, 48 patients with lumbar disc herniation treated in Department of Orthopaedics, Union Hospital of Fujian Medical University were analyzed. Among them, 25 cases were treated with discectomy. 23 cases underwent open laminectomy of nucleus pulposus. The operative time, intraoperative bleeding volume, incision length, postoperative hospitalization time and postoperative complication rate were compared between the two groups by means of statistical method. Macnab lumbar function evaluation criteria were used to evaluate the curative effect of the two groups one year after operation. [results] Age, sex, There was no significant difference in pathological segment and course of disease between the two groups (P 0.05). The blood loss in MED group was 31.72 卤77.34 ml, incision length was 2.02 卤0.20 cm, postoperative hospitalization time was 7.04 卤1.47 days, intraoperative bleeding volume was 107.61 卤160.03 ml, incision length was 4.83 卤1.11 cm, postoperative hospitalization time was 8.21 卤1.63 days in MED group. The incision length and postoperative hospital stay were significantly shorter than those in OD group (P 0.05), while the operative time in MED group was 109.57 卤26.24 min. The operative time of the former group was significantly longer than that of the latter group. The excellent and good rate was 92.00%. In the OD group, 15 cases were excellent, 6 cases were good, 1 case was fair, 1 case was poor. The excellent and good rate was 91.30%. The complication rate was 3 cases in 4%.OD group and 13.04% in 4%.OD group. There was no significant difference in the rate of excellent and good curative effect and the incidence of complications between the two groups (P 0.05). [conclusion] discectomy of nucleus pulposus has less trauma and faster recovery, but the early operation time is longer than that of open surgery. The treatment of lumbar disc herniation by endoscopic discectomy is effective and safe, which is similar to that of open laminectomy.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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