单孔分体内镜技术与单侧双通道内镜技术治疗腰椎间盘突出症的临床疗效对比分析

中华养生保健 ›› 2024, Vol. 42 ›› Issue (18): 180-183.

单孔分体内镜技术与单侧双通道内镜技术治疗腰椎间盘突出症的临床疗效对比分析

薛皓¹, 李安雷², 朱承跃³, 刘成洲⁴, 朱腾月^5,*

1.山东省巨野县人民医院脊柱外科,山东菏泽,274900;
2.山东省东明县人民医院骨一科,山东菏泽,274900;
3.杭州市中医院脊柱微创中心,浙江杭州,310016;
4.山东省临朐县人民医院脊柱骨科,山东潍坊,262600;
5.解放军总医院第六医学中心,北京,100048

出版日期:2024-09-16 发布日期:2024-09-04
通讯作者: ^*朱腾月,E-mail：ztyose@163.com。
作者简介:薛皓（1981—）,男,汉族,籍贯：山东省菏泽市,本科,副主任医师,研究方向：脊柱疾病的微创诊疗。

Comparative Analysis of Clinical Efficacy Between Single Hole Split Endoscopy and Unilateral Dual Channel Endoscopy in the Treatment of Lumbar Disc Herniation

XUE Hao¹, LI An-lei², ZHU Cheng-yue³, LIU Cheng-zhou⁴, ZHU Teng-yue^5,*

1. Department of Spine Surgery, Juye County People's Hospital of Shandong Province, Heze Shandong 274900, China;
2. Department of Osteology, Dongming People's Hospital of Shandong Province, Heze Shandong 274900, China;
3. Spinal Minimally Invasive Center, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou Zhejiang 310016, China;
4. Department of Spinal Department, People's Hospital of Linqu County, Weifang Shandong 262600, China;
5. Sixth Medical Center, PLA General Hospital, Beijing 100048, China

Online:2024-09-16 Published:2024-09-04

摘要/Abstract

摘要： 目的对比分析单孔分体内镜（One-Hole Split Endoscope,OSE）技术和单侧双通道内镜（Unilateral Biportal Endoscopy,UBE）技术治疗腰椎间盘突出症（Lumbar Disc Herniation,LDH）的早期临床疗效。方法回顾分析2021年8月—2022年9月巨野县人民医院、杭州市中医院及东明县人民医院收治且符合选择标准的54例LDH患者,其中,26例采用OSE术治疗（OSE组）,28例采用UBE术治疗（UBE组）。对比两组手术时间、术中出血量、疼痛情况、术后住院时间及恢复优良率。结果所有患者均顺利完成手术,OSE组与UBE组术中出血量、手术时间、切口长度、术后住院时间比较,差异均无统计学意义（P>0.05）。观察对比两组患者术后3个月、6个月及12个月时随访情况,两组间腰腿痛VAS评分和ODI评分差异均无统计学意义（P>0.05）。但随着时间的推移,组内腰腿痛VAS评分和ODI评分均显著减少,各时间点比较,差异均有统计学意义（P<0.05）。UBE组术中均未发生硬膜囊撕裂、神经根损伤等并发症;OSE组术中发生刀口浅表感染1例。结论 OSE与UBE治疗腰椎间盘突出症在术中出血量、手术时间、切口长度、术后住院时间等方面无明显差异,均可有效改善腰椎功能。

关键词: 单孔分体内镜, 单侧双通道内镜, 腰椎间盘突出症, 临床疗效

Abstract: Objective To compare the early clinical efficacy of single hole split endoscopy (OSE) and unilateral dual channel endoscopy (UBE) in the treatment of lumbar disc herniation (LDH). Methods A retrospective analysis was conducted on 54 LDH patients admitted to Juye County People's Hospital、Hangzhou Traditional Chinese Medicine Hospital and Dongming County People's Hospital from August 2021 to September 2022, who met the selection criteria. Among them, 26 cases were treated with OSE surgery (OSE group) and 28 cases were treated with UBE surgery (UBE group). The surgical time, intraoperative bleeding, pain, postoperative hospital stay, and recovery rate between two groups were evaluated and compared. Results All patients successfully completed the surgery, and there was no statistically significant difference in intraoperative bleeding, surgical time, incision length, and postoperative hospital stay between the OSE group and the UBE group (P>0.05). The follow-up results of two groups of patients at 3, 6, and 12 months after surgery were observed and compared, there was no statistically significant difference in VAS and ODI for lower back and leg pain between the two groups (P>0.05). However, over time, the VAS and ODI scores for lower back and leg pain within the group significantly decreased, and the differences at each time point were statistically significant (P<0.05). No complications such as dural sac tear or nerve root injury occurred during surgery in the UBE group; One case of superficial infection of the incision occurred during surgery in the OSE group. Conclusion There is no significant difference between OSE and UBE in terms of intraoperative blood loss, surgical time, incision length, and postoperative hospital stay in the treatment of lumbar disc herniation, and both can effectively improve lumbar spine function.

Key words: single hole split endoscopy, unilateral dual channel endoscopy, lumbar disc herniation, clinical efficacy

中图分类号:

R681.5

薛皓, 李安雷, 朱承跃, 刘成洲, 朱腾月. 单孔分体内镜技术与单侧双通道内镜技术治疗腰椎间盘突出症的临床疗效对比分析[J]. 中华养生保健, 2024, 42(18): 180-183.

XUE Hao, LI An-lei, ZHU Cheng-yue, LIU Cheng-zhou, ZHU Teng-yue. Comparative Analysis of Clinical Efficacy Between Single Hole Split Endoscopy and Unilateral Dual Channel Endoscopy in the Treatment of Lumbar Disc Herniation[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(18): 180-183.

参考文献

[1] AWAD J N, MOSKOVICH R.Lumbar disc herniations: surgical versus nonsurgical treatment[J].Clin Orthop Rel Res,2021,443(443):183-197.
[2] LURIE J D, TOSTESON T D, TOSTESON A N.Surgical versus non-operative treatment for lumbar disc herniation: Eight-year results for the Spine Patient Outcomes Research Trial (SPORT)[J].Spine Journal Meeting Abstracts,2015,7(10):3-16.
[3] YU X, YUE H, WEI H, et al.Comparative Study of Unilateral Biportal Endoscopic and Traditional Open Surgery in the Treatment of Lumbar Disc Herniation[J].Alternative therapies in health and medicine, 2023,11(22):25-29.
[4] ZHITONG H E.Clinical Effect of Minimally Invasive Surgery Through Intervertebral Foraminal Endoscope for Lumbar Disc Herniation[J].Chinese and Foreign Medical Research,2023,21(15):40-44.
[5] AYGUN H, ABDULSHAFI K.Unilateral Biportal Endoscopy Versus Tubular Microendoscopy in Management of Single Level Degenerative Lumbar Canal Stenosis: A Prospective Study[J].Clinical Spine Surgery,2021,6(22):117-126.
[6] 张玉红,张民,戴国华,等.单孔分体内镜治疗中重度腰椎管狭窄症的早期临床疗效[J].中国脊柱脊髓杂志,2023,6(5):41-49.
[7] 中国康复医学会脊柱脊髓专业委员会基础研究与转化学组.腰椎间盘突出症诊治与康复管理指南[J].中华外科杂志,2022,60(5):401-408.
[8] 张波波,侯东峰,王莹,等.椎间孔镜下靶点穿刺治疗游离脱垂型腰椎间盘突出症的临床疗效分析[J].中国现代医学杂志,2021,31(23):62-66.
[9] 朱承跃,张良平,程伟,等.单侧双通道脊柱内镜下髓核摘除术联合纤维环缝合术治疗腰椎间盘突出症早期临床疗效[J].中国修复重建外科杂志,2022,36(10):1186-1191.
[10] 邵荣学,张伟,朱承跃,等.经皮单边双通道内镜技术治疗高位腰椎间盘突出症的短期临床疗效[J].中国内镜杂志,2023,29(10):1-11.
[11] 贾高永,潘浩,程伟,等.单侧双通道内镜下经对侧椎板下入路治疗高度游离型腰椎间盘突出症的疗效[J].江苏医药,2023,49(1):68-73.
[12] 朱承跃,高文硕,潘浩,等.单侧双通道内镜治疗极外侧型腰椎间盘突出症的疗效[J].江苏医药,2022,48(5):477-480.
[13] 李恒德,易仁丰,范友兵,等.单侧双通道内镜技术与后路椎间孔镜技术治疗腰椎间盘突出症的疗效及安全性分析[J].现代医学与健康研究电子杂志,2023,7(8):785-789
[14] 胡震,杨阳,赵树雄,等.单侧双通道内镜技术的临床应用与展望[J].解放军医学杂志. 2023,2(5):5-8.
[15] 范海涛,曹乐,朱亚坤,等.脊柱内镜下经椎板间隙扩大入路治疗腰椎间盘突出症[J].中国微创外科杂志,2021,21(5):5-8.
[16] 刘鑫,张强,朱锴,等.单通道分体内镜治疗神经根型颈椎病的疗效[J].滨州医学院学报,2023,46(4):47-51
[17] 刘昌震,黄卫国,李骥征,等.单孔分体内镜辅助后外侧入路腰椎椎体间融合术治疗L_4、5退变性腰椎滑脱症的临床疗效分析[J].中国修复重建外科杂志,2023,37(8):21-25
[18] 杨德富,田园,李金杰,等.经侧后路椎间孔镜下椎间盘髓核摘除术对腰椎间盘突出症患者术后疼痛程度及腰椎功能的影响[J].哈尔滨医药,2021,41(6):3-6.
[19] 管树军. 侧后方入路与椎板间隙入路经皮椎间孔镜治疗中央型腰椎间盘突出症的对比研究[J].实用医院临床杂志,2020,17(2):4-8.