Wang Liren, Guo Xing, Song Zhenjie, Tang Hanwu, Guo Haiwei, Li Ying
The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine, Guangzhou, Guangdong, China.
Front Neurol. 2025 Jun 18;16:1551742. doi: 10.3389/fneur.2025.1551742. eCollection 2025.
OBJECTIVE: The perioperative blood loss of percutaneous endoscopic interlaminar discectomy (PEID), unilateral biportal endoscopic (UBE) and open fenestration discectomy (OPD) was compared to provide reference for the selection of clinical surgical methods. METHODS: The clinical data of 260 patients with lumbar disc herniation who underwent PEID, UBE or OPD surgery from March 2020 to February 2024 were retrospectively analyzed, including 100 patients who received PEID surgery, 100 patients who received UBE surgery, and 60 patients who received OPD surgery. Total blood loss and hidden blood loss were calculated according to the linear equation of circulating blood volume, and the hidden blood loss was statistically compared among the three groups. RESULTS: In terms of perioperative total blood loss and visible blood loss, the OPD group had the highest total blood loss (408.46 ± 116.89 mL) and visible blood loss (127.17 ± 24.22 mL), followed by the UBE group (304.46 ± 87.55 mL and 51.00 ± 11.15 mL respectively). The PEID group was the least (152.87 ± 54.48 mL and 18.75 ± 5.09 mL). Both the overall differences among the three groups and the pairwise differences were statistically significant ( < 0.05). As for hidden blood loss, the results indicated significant differences between the PEID and UBE groups ( < 0.05), as well as between the PEID and OPD groups ( < 0.05). However, no significant difference was observed between the OPD group and the UBE group ( = 0.22). In terms of operation time, UBE group had the longest operation time (129.67 ± 30.56 min), and OPD group had the shortest operation time (78.73 ± 11.80 min), with statistical difference ( < 0.05). CONCLUSION: In terms of perioperative blood loss, the PEID group was more minimally invasive than the UBE and OPD groups. Compared with OPD group, UBE group was less invasive, but did not significantly reduce the amount of hidden blood loss after surgery. In terms of operation time, UBE group had the longest operation time and OPD group had the shortest operation time. In terms of hospitalization days, OPD group had the longest hospital stay. In terms of total hospitalization cost, UBE group had the highest total hospitalization cost and PEID group had the lowest total hospitalization cost. The clinician should choose the appropriate surgical plan according to the actual situation of the patient to ensure the efficacy and safety of the operation.
目的：比较经皮内镜椎间孔入路椎间盘切除术（PEID）、单侧双通道内镜手术（UBE）和开放开窗椎间盘切除术（OPD）的围手术期失血量，为临床手术方式的选择提供参考。 方法：回顾性分析2020年3月至2024年2月行PEID、UBE或OPD手术的260例腰椎间盘突出症患者的临床资料，其中接受PEID手术100例，接受UBE手术100例，接受OPD手术60例。根据循环血容量线性方程计算总失血量和隐性失血量，并对三组隐性失血量进行统计学比较。 结果：围手术期总失血量和显性失血量方面，OPD组总失血量最高（408.46±116.89ml），显性失血量最高（127.17±24.22ml），其次为UBE组（分别为304.46±87.55ml和51.00±11.15ml）。PEID组最少（152.87±54.48ml和18.75±5.09ml）。三组总体差异及两两比较差异均有统计学意义（<0.05）。隐性失血量方面，结果显示PEID组与UBE组之间差异有统计学意义（<0.05），PEID组与OPD组之间差异有统计学意义（<0.05）。然而，OPD组与UBE组之间未观察到显著差异（=0.22）。手术时间方面，UBE组手术时间最长（129.67±30.56分钟），OPD组手术时间最短（78.73±11.80分钟），差异有统计学意义（<0.05）。 结论：围手术期失血量方面，PEID组比UBE组和OPD组更微创。与OPD组相比，UBE组侵入性较小，但术后隐性失血量未显著减少。手术时间方面UBE组最长，OPD组最短。住院天数方面，OPD组住院时间最长。总住院费用方面，UBE组最高，PEID组最低。临床医生应根据患者实际情况选择合适的手术方案，以确保手术疗效和安全性。
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