作　　者： (）;

机构地区： 广州中医药大学

出　　处： 《中国骨与关节杂志》 2018年第10期738-743,共6页

摘　　要： 目的探讨TESSYS技术与椎间盘镜下治疗单节段腰椎间盘突出症的短期疗效。方法选取我院2015年7月至2017年7月骨科住院手术的腰椎间盘突出症患者93例,采用随机数字表法,将其随机分为实验组(TESSYS技术组)及对照组(椎间盘镜技术组)。对比两组手术时间、切口长度、术中出血量、术后下床时间、卧床时间、是否存在并发症等情况;对比术前、术后1、3、6、12、24个月的疼痛视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(oswestry disability index,ODI)、日本骨科协会(Japanese orthopaedic association,JOA)评分;于术后12个月根据MacNab标准进行疗效评估。结果实验组患者手术时间[(56.92±23.83) min vs.(71.88±20.11) min,t=1.658,P=0.045]、切口长度[(0.89±0.13) cm vs.(3.59±0.92) cm,t=15.784,P=0.000]、术中出血量[(17.74±5.63) ml vs.(93.92±40.55) ml,t=27.944,P=0.000]、术后下床时间[(24.88±1.95) h vs.(72.77±3.74) h,t=4.332,P=0.000]、卧床时间[(5.02±1.22)天vs.(14.78±3.86)天,t=4.332,P=0.001]均优于对照组。试验组术后1个月ODI评分[(16.99±2.77)vs.(19.07±2.14)]、JOA评分[(18.44±1.52) vs.(17.78±1.59)]、下肢VAS评分[(6.48±1.34) vs.(7.15±1.42)]、腰部VAS评分[(3.11±1.02) vs.(3.56±1.24)]均优于对照组,且差异有统计学意义(P<0.05);术后3、6、12、24个月,两组VAS评分、ODI评分、JOA评分的差异均无统计学意义(P>0.05)。术后12个月两组疗效差异均无统计学意义(P>0.05)。术后12个月,试验组优良率与对照组比较差异无统计学意义(86.67%vs. 87.50%,P>0.05)。结论与椎间盘镜治疗术相比较,经皮椎间孔镜下TESSYS技术治疗腰椎间盘突出症有损伤小、出血量少、恢复速度快等优势,是一种值得临床推广的手术方式。 Objective To observe the short-term clinical efficacy between TESSYS technology and intervertebral disc microscopy in the treatment of lumbar disc herniation. Methods From July 2015 to July 2017, 93 patients were collected. By random number table method, all were randomly divided into the experiment group（ TESSYS technology group） and control group（ intervertebral disc microscopy group）. Operation time, incision length, intraoperative blood loss, postoperative mobilization time, bedridden time, complications were compared between the 2 groups. Visual analogue scale（ VAS）, Oswestry disability index（ ODI） and Japanese orthopaedic association（ JOA） scores were compared before operation, 1 month, 3 months, 6 months, 12 months and 24 months after operation. Clinical effects were evaluated according to MacNab standard 12 months after operation. ResultsThe operation time [（ 56.92 ± 23.83） min vs.（ 71.88 ± 20.11） min, t = 1.658, P = 0.045 ], incision length [（ 0.89 ± 0.13） cm vs.（ 3.59 ± 0.92） cm, t = 15.784, P = 0.000 ], intraoperative blood loss [（ 17.74 ± 5.63） ml vs.（ 93.92 ± 40.55） ml, t = 27.944, P = 0.000 ], postoperative mobilization time [（ 24.88 ± 1.95） h vs.（ 72.77 ± 3.74） h, t = 4.332, P = 0.000 ], and bedridden time [（ 5.02 ± 1.22） d vs.（ 14.78 ± 3.86） d, t = 4.332, P = 0.001 ] in the experiment group were better than those in the control group. One month after surgery, ODI score [（ 16.99 ± 2.77） vs.（ 19.07 ± 2.14） ], JOA score [（ 18.44 ± 1.52） vs.（ 17.78 ± 1.59） ], lower extremity VAS score [（ 6.48 ± 1.34） vs.（ 7.15 ± 1.42） ] and waist VAS score [（ 3.11 ± 1.02） vs.（ 3.56 ± 1.24） ] in the experiment group were significantly better than those in the control group with statistical differences（ P〈0.05）. At 3, 6, 12 and 24 months after operation, there were no significant differences in the VAS scores, ODI scores and JOA scores between the 2 groups（ P〈0.05）. There were no significant differen

关 键 词： 腰椎 内窥镜 最小侵入性外科手术 椎间盘移位

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