摘要
目的 分析复发性腰椎间盘突出症（RLDH）患者开展治疗中经皮椎间孔镜技术（PTED）的应用效果。方法 选取2023年9月至2024年8月收治的RLDH患者80例，经随机数字表法对其分组，为观察组和对照组，各40例，依次开展PTED、传统椎板开窗髓核摘除术（TFD）治疗，对比围手术期指标、治疗前后腰椎活动功能、腰背肌生物力学性能、疼痛介质水平变化情况。结果 观察组围手术期指标均低于对照组，治疗后腰椎活动功能高于对照组，腰背肌生物力学性能优于对照组，疼痛介质水平低于对照组（P<0.05）。结论 PTED技术在治疗RLDH中效果良好，可改善腰椎功能等指标且并发症较少，值得应用。
关键词： 复发性腰椎间盘突出症；疼痛介质；经皮椎间孔镜技术；腰背肌生物力学性能
Abstract
Objective To analyze the application effect of percutaneous endoscopic discectomy (PTED) in patients with recurrent lumbar disc herniation (RLDH). Methods A total of 80 patients with RLDH admitted from September 2023 to August 2024 were selected and randomly divided into an observation group and a control group, each consisting of 40 cases. Both groups underwent PTED and traditional laminotomy and discectomy (TFD) respectively. The perioperative indicators, lumbar spine function before and after treatment, biomechanical performance of the back muscles, and changes in pain mediator levels were compared. Results The perioperative indicators in the observation group were all lower than those in the control group. After treatment, the lumbar spine function was higher than in the control group, the biomechanical performance of the back muscles was better than in the control group, and the level of pain mediators was lower than in the control group (P<0.05). Conclusion PTED technology is effective in treating RLDH, improving lumbar spine function and other indicators with fewer complications, making it worthy of application.
Key words： Recurrent lumbar disc herniation; Pain mediators; Percutaneous transforaminal endoscopic lumbar disc technology; Biomechanical properties of lumbar back muscles
参考文献 References
[1] 安博琛,任博文,刘义灏,刘庆祖,刘重阳,刘建恒,毛克亚.MIS-TLIF治疗经皮椎间孔镜术后复发性腰椎间盘突出症的临床疗效研究[J].解放军医学院学报,2024, 45(10): 1011-1016.
[2] 张博,朱红鹤,董晖,王坤,许留振,李亚伟,梅伟.经皮椎间孔镜技术治疗复发性腰椎间盘突出症的临床疗效[J].中国微创外科杂志,2023,23(11):813-817.
[3] 孔维邦,范世昌,王剑飞,张立东,温应辉.经皮椎间孔镜不同进针技术治疗腰椎间盘突出症患者的效果对比[J].临床医学工程,2024,31(2):141-142.
[4] 罗盛中,张国福,程细高.网格状定位器在青壮年腰椎间盘突出症经皮椎间孔镜技术中的应用[J].局解手术学杂志,2024,33(9):805-809.
[5] 徐小平,严小虎,潘显明.经皮椎间孔镜与经椎间孔腰椎椎体间融合术治疗复发性腰椎间盘突出症的疗效比较[J].颈腰痛杂志,2021,42(1):66-69.
[6] 刘智伟,陆芳,康亚娟,孔亚荣,杨朔,白晓亮,连勇.经皮椎间孔镜髓核摘除术治疗腰椎间盘突出症的疗效及对腰背肌生物力学性能、疼痛介质的影响[J].临床和实验医学杂志,2024,23(10):1052-1056.
[7] 高利峰,刘雅普,李鹏,郑笑臣,王松茂,徐永辉,候秀伟,吴广良.经皮椎间孔镜技术治疗腰椎固定术后邻近节段椎间盘突出症[J].颈腰痛杂志,2024,45(3):442-445.
[8] 甄瑞鑫,马桂云,史凡祺,常成兵,安永胜.新型三轴调节式定位器辅助经皮椎间孔镜手术治疗多节段腰椎间盘突出症效果及初步随访[J].河北医科大学学报,2024, 45(8): 927-933.
[9] 白晶晶,王向阳,刘力.不同入路椎间孔镜技术治疗高位腰椎间盘突出症的效果及随访复发影响因素分析[J].临床医学研究与实践,2024,9(24):26-29.
[10] 郭龙,诸晖,陈冰,周嵘,陶德刚,赖爱宁,于凤宾,黄飞.经皮椎间孔镜治疗腰椎间盘突出症的疗效及对炎症因子的干预作用、疗效影响因素分析[J].医师在线,2024, 14(1): 61-65.
[11] 陆军海,卢明南,蓝根,罗绍坚,范武.经皮椎间孔镜技术与传统椎板开窗技术治疗复发性腰椎间盘突出症的效果比较[J].蛇志,2022,34(2):167-173.
[12] 赵海泉.弥散张量成像技术评估腰椎间盘突出症经皮椎间孔镜髓核摘除术后受压神经根微观结构改善的效果分析[J].中国药业,2024,33(S01):120-122.
[13] 汪红亮,周捷,李健,周涛,查本义,吴健.侧方入路经皮椎间孔镜技术治疗钙化型腰椎间盘突出症的临床效果[J].中国医药导报,2024,21(9):99-103.