摘要
目的研究经皮椎间孔镜椎间盘切除术(PTED)结合独活寄生汤治疗腰椎间盘突出症(LDH)的效果。方法60例LDH患者,依据交替分组法分成观察组与对照组,各30例。对照组采用PTED治疗,观察组在对照组基础上结合独活寄生汤治疗。比较两组手术及恢复指标[术中出血量、手术时间、腰椎疼痛数字评分法(NRS)评分、术后卧床时间、住院时间],日本骨科协会评估治疗分数(JOA)、Oswestry功能障碍指数问卷表(ODI)、日常生活能力量表(ADL)评分,临床症状消失时间,并发症发生情况。结果观察组患者的腰椎NRS评分(3.24±1.36)分低于对照组的(5.35±2.47)分,术后卧床时间(28.55±3.96)h、住院时间(7.47±2.38)d短于对照组的(35.28±3.85)h、(12.55±2.47)d,差异具有统计学意义(P<0.05)。两组患者的术中出血量、手术时间比较差异均无统计学意义(P>0.05)。术前,两组的ODI、ADL评分比较差异均无统计学意义(P>0.05);术后3个月,两组ODI评分均较术前降低,ADL评分、JOA评分均较术前升高,观察组ODI评分(15.27±3.55)分低于对照组的(18.66±3.56)分,ADL评分(87.47±10.55)分、JOA评分(24.25±2.87)分均高于对照组的(74.76±12.56)、(19.26±3.45)分,差异具有统计学意义(P<0.05)。观察组患者的腰痛、下肢放射性疼痛、下肢麻木、下肢无力消失时间分别为(9.72±1.38)、(3.13±0.75)、(3.29±1.03)、(5.38±2.58)d,均短于对照组的(14.74±2.58)、(6.54±1.81)、(5.42±1.27)、(8.96±3.19)d,差异具有统计学意义(P<0.05)。观察组并发症发生率6.67%明显低于对照组的26.67%,差异具有统计学意义(P<0.05)。结论LDH患者采用PTED结合独活寄生汤治疗,可有效减轻患者症状,改善腰椎功能,降低术后并发症的发生几率,值得借鉴。
Objective To study the effect of percutaneous transforaminal endoscopic discectomy(PTED)combined with Duhuo Jisheng Decoction in the treatment of lumbar disc herniation(LDH).Methods A total of 60 patients with LDH were divided into an observation group and a control group according to alternate grouping method,with 30 cases in each group.The control group was treated with PTED,and the observation group was treated with modified Duhuo Jisheng Decoction on the basis of control group.Both groups were compared in terms of surgical and recovery indexes[intraoperative blood loss,operative time,lumbar numerical rating scale(NRS)score,postoperative time in bed,length of hospital stay],Japanese Orthopaedic Association(JOA score),Oswestry Disability Index(ODI)score,Activities of Daily Living Scale(ADL)score,and disappearance time clinical symptom,and occurrence of complications.Results The lumbar NRS score of(3.24±1.36)points in the observation group was lower than that of(5.35±2.47)points in the control group;the duration of bed rest of(28.55±3.96)h and hospital stay of(7.47±2.38)d in the observation group were shorter than those of(35.28±3.85)h and(12.55±2.47)d in the control group;the differences were statistically significant(P<0.05).There were no statistically significant differences in intraoperative blood loss and operative time between the two groups(P>0.05).Before surgery,there were no statistically significant differences in ODI and ADL scores between the two groups(P>0.05).At 3 months after surgery,ODI score in both groups was lower than that before surgery in this group,and ADL score and JOA score were higher than those before surgery in this group;ODI score of(15.27±3.55)points in the observation group was lower than that of(18.66±3.56)points in the control group;ADL score of(87.47±10.55)points and JOA score of(24.25±2.87)points in the observation group were higher than those of(74.76±12.56)and(19.26±3.45)points in the control group;the differences were statistically significant(P<0.05).The disappearance time of lower back pain,lower limb radiation pain,lower limb numbness and lower limb weakness in the observation group were(9.72±1.38),(3.13±0.75),(3.29±1.03)and(5.38±2.58)d,which were shorter than those of(14.74±2.58),(6.54±1.81),(5.42±1.27)and(8.96±3.19)d in the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 6.67%,which was significantly lower than that of 26.67%in the control group,and the difference was statistically significant(P<0.05).Conclusion In LDH patients,PTED combined with Duhuo Jisheng Decoction can effectively reduce the symptoms of patients,improve the lumbar function,and reduce the occurrence of postoperative complications,which is worthy of reference.
作者
蔡为民
陈国锋
纪建政
汪守伍
王少甫
徐星
张成刚
孙轩
CAI Wei-min;CHEN Guo-feng;JI Jian-zheng(Department of Orthopedics and Traumatology,Suqian Hospital of Traditional Chinese Medicine,Suqian 223800,China)
出处
《中国实用医药》
2023年第24期126-129,共4页
China Practical Medicine
关键词
经皮椎间孔镜椎间盘切除术
独活寄生汤
腰椎间盘突出症
腰椎功能
并发症
Percutaneous transforaminal endoscopic discectomy
Duhuo Jisheng Decoction
Lumbar disc herniation
Lumbar function
Complications
