摘要
目的回顾性分析经皮腰椎间盘切割术（PLD）与显微内镜腰椎间盘摘除术（MED）治疗腰椎间盘突出症的远期疗效与生活质量，探讨每种术式的临床应用优势。方法采用查阅原始病案、信函与电话相结合的随访方式，对2000年1月至2002年3月间来东南大学附属中大医院接受PLD治疗的患者共104例及MED治疗的患者82例进行远期随访研究，随访的内容包括Oswestry功能障碍指数（ODI）、JOA腰痛疗效评定标准（JOA）、SF-36量表（SF-36）的评分，使用配对t检验、x^2检验及Fisher精确概率法等方法进行统计学分析。结果PLD组和MED组评价随访时间分别为5．2～7．3（6．6±0．7）年和5．3—7．2（6．4±0．5）年。MED组的远期ODI、SF-36评分要好于PLD组（秩和检验，P值分别为0．0397和0．0582），JOA信函问卷评分组间差异无统计学意义（秩和检验，P值为0．9742）；而MED组的住院时间、住院费用则明显长于或多于后者（方差分析，均P〈0．01）；远期并发症发生率分别为MED组3．49％，PLD组未出现手术相关并发症。结论MED或PLD治疗腰椎间盘突出症均具有创伤小、恢复快、疗效好且稳定的特点。MED的临床远期疗效高于PLD，但是其并发症稍高，住院时间和费用也有所提高。
Objective To evaluate the long-term effects of percutaneous lumbar discectomy（PLD） and microendoscopic discectomy（MED） in treatment of lumbar disc herniation. Methods A questionnaire survey by letter and telephone was conducted among 104 patients undergoing PLD and 82 patients undergoing MED during January 2000 to March 2002, to investigate the Oswestry disability index （ ODI ）, Short Form- 36 （SF-36） score, and Japanese Orthopedic Association （JOA） score. Results The excellent/good rate （ ODI score = 0-20% ） of the MED group was 79. 27%, significantly higher than that of the PLD group （71.15%, P =0. 0397）. However, longer The hospitalization duration of the MED group was 11,6 d, significantly longer than that of the PLD group （7.9 d, P 〈 0. 01 ）, and the mean cost of the MED group was, significantly higher than that of the PLD group （P 〈 0. 01 ）. Long-term complications were observed in 3 patients of the MED group （3.49%） while none in the PLD group. Conclusion Both PLD and MED are minimally-invasive-technique with a long-term efficacy and safety on lumbar disc herniation. Although the long-term outcome of the MED group is better than PLD, the complication rate, hospitalization duration, and cost of the MED group are higher.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2009年第11期750-753,共4页
National Medical Journal of China
关键词
椎间盘移位
椎间盘切除术
经皮
随访研究
Intervertebral disk displacement
Diskectomy,percutaneous
Follow-up studies
