胡志伏

[摘要] 目的 探讨腰椎间盘突出症者以经皮椎间孔脊柱内窥镜下腰椎间盘切除术（PTED）治疗的有效性。 方法 方便选取该院2015年3月—2016年4月期间收治的42例腰椎间盘突出症者为研究对象，所有患者均行PTED治疗，观察患者腰椎间盘突出改善情况，统计术后并发症情况，对治疗前后患者疼痛、功能障碍评分比较。 结果 该次42例患者，治疗有效者36例，无效4例，恶化2例，PTED用于腰椎间盘突出症治疗有效率为85.7%。治疗后患者疼痛、功能障碍明显改善，术后无严重并发症。 结论 腰椎间盘突出症者以PTED治疗，疗效高，患者术后恢复好，并发症少。

[关键词] PTED；安全性；疗效；腰椎间盘；突出

[中图分类号] R687 [文献标识码] A [文章编号] 1674-0742（2017）08（a）-0079-03

[Abstracts] Objective This paper tries to observe the effectiveness of treatment of the lumbar intervertebral dissection of lumbar vertebrae under endoscopic spinal endoscopy（PTED）. Methods 42 cases of lumbar intervertebral disc protrusion in this hospital from March 2015 to April 2016 were convenient selected； all patients received PTED treatment， the improvement conditions of patients with lumbar disc were observed， postoperative complications were concluded， pain and dysfunction score of the patients before and after the treatment were compared. Results Among the 42 patients， 36 cases were treated effectively， 4 cases were invalid， 2 cases were aggravated， and the effectiveness rate of the treatment was 85.7%. After the treatment， the patients pain and dysfunction were significantly improved and no serious complications were reported. Conclusion The curative effect of PTED for lumbar intervertebral disc protrusion is good， and patients recover well after operation with fewer complications.

[Key words] PTED； Security； Curative effect； Lumbar disc； Prominent

腰椎间盘突出症临床表现以患者下肢活动受限、腰腿出现不同程度疼痛为主，发病机制为机体椎间盘损伤、突出、组织结构继发性改变所致，若不及时治疗对患者日常工作、生活、学习均会造成影响[1]。目前该病临床治疗手段较多，包括手术、推拿、针灸等，其中对于病情较轻者可先采取保守治疗如针灸、推拿等，但对于病程长、保守治疗无效者，临床多会行手术治疗。该文观察2015年3月—2016年4月期间42例腰椎间盘突出症者以PTED治疗的有效性、安全性，现报道如下。

1 资料与方法

1.1 一般资料

方便选取该院收治的42例腰椎间盘突出症者为研究对象，患者术前有明显下肢放射性疼痛、腰骶部疼痛，以及下肢麻木无力等症状，符合腰椎间盘突出症临床诊断标准[2]，所有患者均为保守治疗无效者，排除合并其他脊柱疾病、腰椎退行性病变者，排除因其他原因致椎管狹窄者，排除临床资料不全者。……