【摘要】 目的：探讨腰椎间盘突出症应用经皮椎间孔镜椎间盘切除术的治疗效果及对腰椎功能的改善作用。方法：选取2017年2月-2018年2月本院骨科收治的腰椎间盘突出症患者80例，按照随机数字表法将患者分为对照组和观察组，每组40例。对照组采用标准后路开窗腰椎间盘切除术治疗，观察组采用经皮椎间孔镜椎间盘切除术治疗，对比两组的手术情况、术后日常生活能力、治疗效果、腰椎功能改善情况。结果：观察组术中出血量、手术切口长度、住院天数均少于对照组，差异均有统计学意义（P<0.05）。观察组术后ODI指数低于对照组，治疗优良率、腰椎功能改善优良率均高于对照组，差异均有统计学意义（P<0.05）。结论：针对腰椎间盘突出症患者，应用经皮椎间孔镜椎间盘切除术治疗，可显著提高手术质量，改善功能障碍状况，提高治疗效果，增强腰椎功能改善情况。

【关键词】 腰椎间盘突出症; 经皮椎间孔镜; 椎间盘切除术; ODI指数; 腰椎功能

【Abstract】 Objective：To investigate the effect of percutaneous transforaminal discectomy and the improvement of lumbar function in lumbar disc herniation.Method：80 patients with lumbar disc herniation admitted to department of orthopedics in our hospital from February 2017 to February 2018 were selected.Patients were divided into control group and observation group according to the random number table method，with 40 cases in each group.The control group was treated with standard posterior fenestration lumbar discectomy，the observation group was treated with percutaneous transforaminal discectomy.The operative status，postoperative daily living ability，treatment effect and improvement of lumbar function of the two groups were compared.Result：The amount of intraoperative blood loss，the length of surgical incision and the length of hospital stay in the observation group were all less than those in the control group，with statistically significant differences（P<0.05）.The postoperative ODI index of the observation group was lower than that of the control group，the excellent and good rate of treatment and the excellent and good rate of lumbar function improvement in observation group were higher than those of the control group，with statistically significant differences（P<0.05）.Conclusion：For patients with lumbar intervertebral disc herniation admitted to the clinic，the application of percutaneous intervertebral foraminoscope discectomy can significantly improve the quality of surgery，improve the status of dysfunction，improve the treatment effect，and enhance the improvement of lumbar vertebral function.

【Key words】 Lumbar disc herniation; Percutaneous transforaminal; Discectomy; ODI index; Lumbar function

First-authors address：Xianning Central Hospital，Xianning 437000，China

doi：10.3969/j.issn.1674-4985.2019.11.031

腰椎間盘突出症为临床重要诱导腰腿疼痛因素，由炎性因子刺激所致，外力作用下，促使纤维环发生破裂，腰椎间盘出现退行性改变，造成髓核向后突出或脱出，对脊髓神经根及马尾神经构成压迫，最终引起腰部局部疼痛与下肢放射性疼痛[1-2]。近年来，随着老龄化人口规模的扩大，加之公众生活方式的改变，本病发生率逐年上升。以往多应用传统后路开放手术予以治疗，但出血量大，创伤较严重，有较高并发症风险。随着微创医学的进步，经皮椎间孔镜技术渐趋成熟，此项术式可有效规避上述术式的不足，出血量少、创口小，术后康复迅速，在改善腰椎间盘突出症预后方面作用十分突出[3-4]。本研究选取相关病例，应用经皮椎间孔镜行椎间盘切除术，预后理想，现报道如下。

1 资料与方法

1.1 一般资料 选取2017年2月-2018年2月本院骨科收治的腰椎间盘突出症80例。……