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椎间孔镜BEIS技术治疗腰椎间盘突出症的临床研究

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目的 探讨椎间孔镜宽视野、简易、即刻手术(BEIS)技术治疗腰椎间盘突出症(LDH)的临床优势。方法 采用随机数字表法将 2015 年 1 月至 2022 年 12 月临沂市中心医院疼痛科收治的 400 例LDH患者分为两组,各200 例,对照组予传统椎板开窗减压髓核摘除术治疗,研究组予椎间孔镜BEIS技术治疗,观察两组手术时间、术中出血量、术后首次下床活动时间、住院时间、并发症发生率及复发率;并比较手术前后两组患者视觉模拟评分法(VAS)、日本骨科协会(JOA)评分标准评定脊柱功能、Oswestry功能障碍指数(ODI),半年后使用改良MacNab标准评价疗效。结果 研究组手术时间和术后首次下床活动时间、住院时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0。05);研究组术后并发症发生率低于对照组,差异有统计学意义(P<0。05),但两组随访复发率差异无统计学意义(P>0。05);两组术前VAS评分差异无统计学意义(P>0。05),研究组术后 24 h、术后 48 h、术后 1 周时VAS评分低于对照组,差异有统计学意义(P<0。05);组间术前JOA评分与ODI评分差异无统计学意义(P>0。05);两组术后JOA评分与ODI评分较术前均有改善,其中研究组JOA评分高于对照组,ODI评分低于对照组,差异有统计学意义(P<0。05);研究组治疗有效率(94。27%)高于对照组(85。13%),差异有统计学意义(P<0。05)。结论 椎间孔镜BEIS技术是治疗LDH的有效术式,不仅疗效满意,且安全性高,术后恢复快,值得临床应用。
Clinical Study on the Treatment of Lumbar Disc Herniation with Intervertebral Foramen Endoscopic BEIS Technology
Objective To explore the clinical effectiveness of BEIS(broad easy immediate surgery)on the treatment of lumbar disc herniation(LDH).Methods A total of 400 LDH patients admitted to the pain department of Linyi Central Hospita from January 2015 to December 2022 were randomly divided into two groups,with 200 patients in each group.The fenestration discectomy was performed in the control group;BEIS was performed in the study group.Observe the surgical time,intraoperative blood loss,postoperative first time out of bed activity time,length of hospital stay,incidence of complications,and recurrence rate in two groups;And compare the Visual Analog Score(VAS),Japanese Orthopedic Association(JOA)scoring standards for assessing spinal function,and Oswestry Dysfunction Index(ODI)between the two groups of patients before and after surgery,after 6 months of surgery,the treatment outcomes were assessed through the modified MacNab criteria.Results the study group had shorter surgical time,postoperative first time out of bed activity time,and hospital stay compared to the control group,and less intraoperative bleeding compared to the control group,with statistically significant differences(P<0.05);The incidence of postoperative complications in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05),However,there was no significant difference in the recurrence rate between the two groups(P>0.05);There was no statistical difference in the preoperative VAS score results between groups(P>0.05),However,comparing between groups at 24 h,48 h and 1 week,The VAS score of the research group was significantly lower than that of the control group,with statistically significant differences(P<0.05);There was no statistical difference between preoperative JOA score and ODI score between groups(P>0.05);The above scores improved in both groups after surgery compared to before,with the study group having a higher JOA score than the control group and an ODI score lower than the control group,with statistically significant differences(P<0.05);Comparison of overall excellent and excellent rates of efficacy evaluation,The study group(94.27%)was higher than the control group(85.13%),The difference was significant(P<0.05).Conclusion The intervertebral foramen endoscopic BEIS technique is an effective surgical approach for the treatment of LDH.It not only has satisfactory efficacy,but also high safety,fast postoperative recovery,and is worthy of clinical application.

intervertebral foramen mirror BEIS technologylumbar disc herniationcomplications

刘兆斌、刘元涛、杨倩倩、王绍飞、蒋海

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临沂市中心医院 疼痛科,山东 临沂 276400

椎间孔镜BEIS技术 腰椎间盘突出症 并发症

2024

临床研究
西安交通大学

临床研究

影响因子:0.234
ISSN:2096-1278
年,卷(期):2024.32(6)
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