Chang Feng, Zhang Ting, Gao Gang, Yu Chen, Liu Ping, Zuo Genle, Huang Xinhu
Department of Orthopedics (Minimally Invasive Spine Surgery), The Affiliated People's Hospital of Shanxi Medical University, Taiyuan, Shanxi 030012, P.R. China.
Exp Ther Med. 2018 Jan;15(1):295-299. doi: 10.3892/etm.2017.5348. Epub 2017 Oct 20.
This study investigated the therapeutic effect of percutaneous endoscopic lumbar discectomy on lumbar disc herniation, and explored its effect on oxidative stress in patients with lumbar disc herniation. One hundred and ten patients with lumbar disc herniation were selected in The Affiliated People's Hospital of Shanxi Medical University from May 2015 to May 2016. Patients were divided into control group (n=50) and observation group (n=60) according to different surgical methods. Patients in control group were subjected to traditional open discectomy, while patients in observation group were treated with percutaneous endoscopic lumbar discectomy. Surgical-related indicators, ODI and VAS scores before and 3 months after surgery, serum inflammatory factors and oxidative stress indicators were compared between 2 groups. There was no significant difference in operation time between the groups. Blood loss, incision size and time of bed rest in observation group were better than those in control group (P<0.05). Compared with preoperative levels, ODI and VAS scores of the two groups were significantly reduced at 3 months after surgery, but the scores of observation group were significantly higher than those of control group (P<0.05). There were no significant differences in the levels of serum inflammatory factors TNF-α and CRP and oxidative stress indicators MDA, MPO, SOD and TAC between the two groups before surgery (P>0.05). Levels of serum inflammatory factors TNF-α and CRP and oxidative stress indicators MDA and MPO were significantly lower and levels of oxidative stress indicators SOD and TAC were significantly higher in observation group than in control group (P<0.05). Therefore, treatment of lumbar disc herniation with percutaneous endoscopic lumbar discectomy has the advantages of small trauma, less blood loss and fast recovery, and can effectively improve the dysfunction, reduce pain and serum levels of inflammatory factors, and improve the levels of oxidative stress indicators, thereby improving the surgical results. Thus, this method should be considered for wide-use.
本研究探讨经皮内镜下腰椎间盘切除术治疗腰椎间盘突出症的疗效，并探究其对腰椎间盘突出症患者氧化应激的影响。选取2015年5月至2016年5月在山西医科大学附属人民医院就诊的110例腰椎间盘突出症患者。根据不同手术方式将患者分为对照组（n = 50）和观察组（n = 60）。对照组患者接受传统开放性椎间盘切除术，观察组患者接受经皮内镜下腰椎间盘切除术。比较两组患者的手术相关指标、术前及术后3个月的ODI和VAS评分、血清炎症因子及氧化应激指标。两组患者手术时间差异无统计学意义。观察组患者的失血量、切口大小及卧床时间均优于对照组（P < 0.05）。与术前水平相比，两组患者术后3个月的ODI和VAS评分均显著降低，但观察组评分显著高于对照组（P < 0.05）。术前两组患者血清炎症因子TNF-α和CRP水平及氧化应激指标MDA、MPO、SOD和TAC差异无统计学意义（P > 0.05）。观察组患者血清炎症因子TNF-α和CRP水平及氧化应激指标MDA和MPO显著低于对照组，氧化应激指标SOD和TAC显著高于对照组（P < 0.05）。因此，经皮内镜下腰椎间盘切除术治疗腰椎间盘突出症具有创伤小、失血少、恢复快的优点，可有效改善功能障碍，减轻疼痛，降低血清炎症因子水平，提高氧化应激指标水平，从而改善手术效果。因此，该方法应考虑广泛应用。
