CT引导经皮椎间孔镜治疗老年腰椎间盘突出症的疗效观察

发布时间：2019-01-08 14:19

【摘要】：目的:探讨CT引导下经皮椎间孔镜治疗老年性腰椎间盘突出症的临床疗效观察。方法:60例老年性腰椎间盘突出症患者,分为两组(n=30):对照组使用靶点射频联合胶原酶化学溶解术,治疗组使用TESSYS经皮椎间孔镜技术进行治疗。于术前、术后1天、术后3个月和术后6个月分别采用疼痛视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(oswestry disability index,ODI)和改良Macnab标准进行疗效观察。结果:两组患者在治疗后疼痛均得到明显改善,对照组VAS从术前6.57±0.55 cm下降到术后第一天的3.48±0.56 cm(P0.01),ODI(%)值从术前72.73±2.59分下降到术后第1天的29.55±2.32(P0.01);治疗组VAS从术前6.44±0.55 cm下降到术后第1天的2.16±0.64 cm(P0.01),ODI(%)值从术前69.94±2.57分下降到术后第1天的19.18±1.52(P0.01);治疗组术后3个月和术后6个月VAS和ODI(%)值均显著低于对照组(P0.05);对照组优良率达到73.3%;治疗组优良率达到90%。结论:CT引导下的经皮椎间孔镜治疗老年性腰椎间盘突出症疗效明显优于靶点射频联合胶原酶化学溶解术。
[Abstract]:Objective: to investigate the clinical effect of percutaneous foramen endoscopy under CT guidance in the treatment of senile lumbar disc herniation. Methods: sixty patients with senile lumbar disc herniation were divided into two groups: the control group was treated with target radio frequency combined with collagenase chemolysis, and the treatment group was treated with TESSYS percutaneous foramen technique. The curative effect was observed by (visual analogue scale,VAS), Oswestry dysfunction index (oswestry disability index,ODI) and modified Macnab standard before operation, 1 day after operation, 3 months after operation and 6 months after operation. Results: the pain was significantly improved in both groups. The VAS in the control group decreased from 6.57 卤0.55 cm before operation to 3.48 卤0.56 cm on the first day after operation (P0.01). ODI (%) decreased from 72.73 卤2.59 before operation to 29.55 卤2.32 on the first day after operation (P0.01). In the treatment group, VAS decreased from 6.44 卤0.55 cm before operation to 2.16 卤0.64 cm (P0.01), ODI (%) on the first day after operation from 69.94 卤2.57 before operation to 19.18 卤1.52 on the first day after operation. The values of VAS and ODI (%) in the treatment group were significantly lower than those in the control group (P0.05); the excellent and good rate in the control group reached 73.3%; the excellent and good rate in the treatment group reached 90%. Conclusion: CT guided percutaneous foramen endoscopy is superior to target radiofrequency combined with collagenase chemolysis in the treatment of senile lumbar disc herniation.
【作者单位】：南京大学医学院附属鼓楼医院疼痛科;
【分类号】：R687.3

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