作　　者： (殷乐）; (元虎）;

机构地区： 延边大学附属医院,吉林延吉133000

出　　处： 《吉林医学》 2017年第9期1656-1658,共3页

摘　　要： 目的:通过行椎间孔镜下治疗腰椎间盘突出症的术中、术后各项评分指标,来评价椎间孔镜在行腰椎髓核摘除术的学习曲线及近期疗效。方法:对2014年9月~2016年7月就诊于延边大学附属医院,并诊断为单节段单侧腰椎间盘突出症的80例患者,根据手术时间顺序分成A-D(共4组),每组各20例患者。数据收集及统计由未参加手术过程的高年资脊柱外科医师负责。患者术后的VAS,J0A评分,随访期间为术后1~6个月。结果:随访过程中未出现术后椎间隙感染、神经根损伤。各组手术时间A组和其余各组比较具有统计学差异(P<0.05),B组同C、D组比较具有统计学差异(P<0.05),C、D两组比较则无统计学差异(P>0.05)。四组患者术后的VAS、J0A评分均较术前改善明显(P<0.05),术后四组疗效同一时间内比较无明显差异(P>0.05)。结论:(1)椎间孔镜技术大约在40~50例左右达到平台期。(2)术者是否拥有丰富的开放手术经验及相关专业培训是影响学习曲线长短的要素。(3)该术近期疗效确切,远期疗效需要长期随访观察。 Objective To evaluate the learning curve and it’s early therapeutic effects of Percutaneous Transforaminal Endoscopic Discectomy for lumbar disc herniation（ LDH） by means of the scores of intraoperative and postoperative. Method 80 patients diagnosed as single level unilateral LDH were involved from September 2014 to July 2016 in Affiliated Hospital of Yanbian University. The patients were divided into A-D group（ 4 groups） according to the order of operation time,each group had 20 patients. The data was collected and statistically analyzed by one spine surgeon who did not participate in the surgeries. Postoperative VAS（ vasual analogy scale） score and JOA（ Japanese orthopaedic association） score were acquired from 1 to 6months after surgery. Results There was no disc infection,nerve root injury during or after surgeries. There were statistical difference between the group A and the other groups（ P 〈 0. 05）,group B with group C,D were statistically significant（ P 〈 0. 05）,but were no statistically different between group C and D（ P 〉 0. 05）. The JOA and VAS scores were significantly improved after surgery in four groups（ P 〈 0. 05）. However,There was no significant difference between the four groups of Operative effect in the same time（ P 〉 0. 05）. Conclusion（1） A learning curve of Percutaneous Transforaminal Endoscopic Discectomy needs 40-50 cases of repetitions to reach the plateau.（2）Whether the surgeon has a wealth of open surgery experience and related professional training is an important factor affecting the length of the learning curve.（3）The efficacy of this technique is accurate,long term follow-up is needed.

关 键 词： 腰椎间盘突出症 椎间孔镜技术 学习曲线 近期疗效