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关节突定位与滑动联合经皮内镜腰椎间盘切除术对细胞炎症指标及椎间盘突出症的影响。

The effect of locating and sliding of facet combined with percutaneous endoscopic lumbar discectomy on cell inflammatory indicators and the treatment of disc herniation.

机构信息

Department of Orthopedics, Linfen People's Hospital, The Seventh Clinical School of Shanxi Medical University, Shanxi, China.

出版信息

Cell Mol Biol (Noisy-le-grand). 2022 Feb 4;67(5):181-187. doi: 10.14715/cmb/2021.67.5.25.

Abstract

This study aimed to investigate the effects of IL-8, CRP and TXB2 in the treatment of lumbar disc herniation by combining with percutaneous endoscopic discectomy. For this purpose, 290 patients with disc herniation were selected as the research objects and randomly divided into two groups. The control group was treated with traditional intervertebral fenestration of nucleus pulposus, and the research group was treated with joint process location slip technique combined with percutaneous endoscopic lumbar disc discectomy. The clinical efficacy, functional scores and serological indexes of the two groups were compared, and the prognostic value of IL-8, CRP and TXB2 in the treatment of disc herniation by the combination of the sliding technique of facet location and percutaneous endoscopic discectomy was explored. The results showed that the total effective rate of 95.55% in the study group was higher than 79.31% in the control group, and the difference was significant (P<0.05). The operative time, incision length, length of hospital stay and intraoperative blood loss in the study group were lower than those in the control group (P<0.05). JOA score was higher and ODI score was lower in the two groups after surgery than before surgery, and JOA score in the study group was higher than that in the control group, while the ODI score was lower than that in the control group (P<0.05). Il-8, CRP and MDA in 2 groups increased after the operation, while SOD and TXB2 decreased significantly. Il-8, CRP, TXB2 and SOD in the study group were lower than those in the control group, while MDA was higher than those in the control group (P<0.05). ROC curve indicated that the areas under the curves of IL-8, CRP and TXB2 were 0.725, 0.835 and 0.880, and the areas under the curves, sensitivity and specificity of the combined determination were higher than those of any index (P<0.05). In general, compared with traditional interlaminar fenestration of nucleus pulposus, combined with percutaneous endoscopic lumbar disc discectomy has a significant effect on the treatment of disc herniation, and can reduce the levels of IL-8, CRP and TXB2.

摘要

本研究旨在探讨白细胞介素-8(IL-8)、C 反应蛋白(CRP)和血栓素 B2(TXB2)在经皮内镜椎间盘切除术联合治疗腰椎间盘突出症中的作用。为此,选择 290 例椎间盘突出症患者作为研究对象,随机分为两组。对照组采用传统的椎间盘开窗术治疗,研究组采用关节突定位滑切技术联合经皮内镜腰椎间盘切除术治疗。比较两组患者的临床疗效、功能评分和血清学指标,并探讨 IL-8、CRP 和 TXB2 在关节突定位滑切技术联合经皮内镜椎间盘切除术治疗椎间盘突出症中的预测价值。结果显示,研究组总有效率为 95.55%,高于对照组的 79.31%,差异有统计学意义(P<0.05)。研究组的手术时间、切口长度、住院时间和术中出血量均低于对照组(P<0.05)。两组术后的日本骨科协会(JOA)评分均高于术前,Oswestry 功能障碍指数(ODI)评分均低于术前,且研究组的 JOA 评分高于对照组,ODI 评分低于对照组(P<0.05)。两组术后白细胞介素-8(IL-8)、CRP 和丙二醛(MDA)均升高,超氧化物歧化酶(SOD)和 TXB2 均明显降低。研究组的 IL-8、CRP、TXB2 均低于对照组,MDA 高于对照组(P<0.05)。ROC 曲线表明,IL-8、CRP 和 TXB2 的曲线下面积分别为 0.725、0.835 和 0.880,联合检测的曲线下面积、敏感度和特异度均高于任何单一指标(P<0.05)。总之,与传统的椎间盘开窗术相比,经皮内镜椎间盘切除术联合治疗椎间盘突出症的疗效显著,能降低 IL-8、CRP 和 TXB2 的水平。

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