漆海如 曾宪明 刘宝

【摘要】 目的 探讨椎间孔镜技术与骨科开放手术治疗腰椎间盘突出并腰椎管狭窄症的临床疗效。方法 60例腰椎间盘突出并腰椎管狭窄症患者， 随机分为对照组和试验组， 每组30例。对照组给予骨科开放手术治疗， 试验组给予椎间孔镜技术治疗。比较两组患者的手术时间、术中出血量、住院时间、腰椎功能恢复情况。结果 两组手术时间比较， 差异无统计学意义（P>0.05）;试验组术中出血量（25.96±3.62）ml少于对照组的（64.18±3.41）ml， 住院时间（6.13±1.32）d短于对照组的（16.22±1.31）d， 差異均具有统计学意义（P<0.05）。术前， 两组Oswestry功能障碍指数（ODI）评分、日本骨科协会评估治疗（JOA）评分比较， 差异均无统计学意义（P>0.05）;术后7 d， 试验组ODI评分（13.02±1.22）分低于对照组的（18.90±2.52）分， JOA评分（25.12±2.08）分高于对照组的（20.22±2.78）分， 差异均具有统计学意义（P<0.05）。结论 相比于骨科开放手术， 椎间孔镜技术治疗腰椎间盘突出并腰椎管狭窄症， 可缩短住院时间， 减少术中出血量， 腰椎功能恢复好， 值得临床推广及使用。

【关键词】 腰椎间盘突出;腰椎管狭窄症;椎间孔镜技术;骨科开放手术

DOI：10.14163/j.cnki.11-5547/r.2020.20.020

【Abstract】 Objective   To discuss the clinical efficacy of intervertebral foramen and open surgery in orthopedics on the treatment of patients with lumbar disc herniation complicated with lumbar spinal stenosis. Methods   A total of 60 patients with lumbar disc herniation complicated with lumbar spinal stenosis were randomly divided into control group and experimental group， with 30 cases in each group. The control group was treated by open surgery in orthopedics， and the experimental group was treated by intervertebral foramen. The surgery time， amount of intraoperative hemorrhage， hospitalization time and recovery of lumbar function were compared between the two groups. Results   There was no statistically significant difference in surgery time between the two groups （P>0.05）. The amount of intraoperative hemorrhage （25.96±3.62） ml of the experimental group was less than that of the control group （64.18±3.41） ml， and hospitalization time （6.13±1.32） d was shorter than that of the control group （16.22±1.31） d， and the difference was statistically significant （P<0.05）. Before treatment， there was no statistically significant difference in Oswestry disability index （ODI） score and Japanese orthopaedic association（ JOA） score between the two groups （P>0.05）. 7 d after treatment， ODI score （13.02±1.22） points of the experimental group was lower than that of the control group （18.90±2.52） points， and JOA score （25.12±2.08） points was higher than that of the control group （20.22±2.78） points， and the difference was statistically significant （P<0.05）. Conclusion   Compared with open surgery in orthopedics， intervertebral foramen can shorten hospitalization time， reduce amount of intraoperative hemorrhage， and recover the lumbar function of patients with lumbar disc herniation complicated with lumbar spinal stenosis well， which is worthy of clinical promotion and application.

【Key words】 Lumbar disc herniation; Lumbar spinal stenosis; Intervertebral foramen; Open surgery in orthopedics

腰椎間盘突出并腰椎管狭窄症主要因腰椎间盘发生破裂突出或退变， 压迫马尾神经， 为临床常见疾病。腰椎管狭窄症与腰椎间盘突出互相影响， 加重患者病情， 使其生活质量受到严重影响。针对保守治疗无效的患者， 手术为首选治疗方案， 但以往主要手术方式为开放手术， 手术创伤大， 术后恢复慢。随着外科手术技术的发展， 椎间孔镜技术被广泛应用于外科手术中[1]。为探讨椎间孔镜技术与骨科开放手术治疗腰椎间盘突出并腰椎管狭窄症的临床疗效， 特选取2018年6月～2019年12月本院收治的该病患者60例作为研究对象行对比分析， 现将结果报告如下。

1 资料与方法

1. 1 一般资料 选取2018年6月～2019年12月本院收治的腰椎间盘突出并腰椎管狭窄症患者60例， 随机分为对照组和试验组， 每组30例。对照……