【摘要】 [目的]比较内镜与开放腰椎间盘切除术后神经传导与疼痛介质的改变。[方法] 2017年3月—2020年1月100例腰椎间盘突出症患者,采用抽签法分为两组。其中,51例采用内镜下髓核摘除(内镜组),49例采用传统开窗髓核摘除(传统组)。比较两组患者的临床结果、神经传导、疼痛介质水平变化情况。[结果]内镜组手术时间、切口长度、术中出血量、术后下床时间及住院时间均显著优于传统组(P<0.05)。术后两组神经传导速度水平均显著升高(P<0.05),且内镜组腓肠神经、隐神经、胫神经及腓总神经传导速度均显著优于传统组(P<0.05)。术后两组5-HT、PGE2水平均显著降低(P<0.05),且内镜组均显著优于传统组(P<0.05)。[结论]内镜下髓核摘除治疗腰椎间盘突出症效果显著,可有效改善神经传导与疼痛介质水平。更多还原

【Abstract】 [Objective] To compare the changes of nerve conduction and pain mediators after endoscopic versus open lumbar discectomy. [Method] From March 2017 to January 2020, 100 patients who were undergoing surgical treatment for lumbar intervertebral disc herniation were randomly divided into two groups by lottery. Among them, 51 patients received endoscopic discectomy(the endoscopic group),while the other 49 patients underwent traditional open discectomy by fenestration(the traditional group). The clinical results, nerve conduction, and changes in pain mediator levels were compared between the two groups. [Results] The endoscopic group was significantly superior to the traditional group in terms of operation time, incision length, intraoperative blood loss, postoperative time to get out of bed and hospital stay(P<0.05). The nerve conduction velocities increased significantly after surgery in both group(P<0.05), and the endoscopic group proved significantly better than the traditional group regarding to conduction velocities of the sural nerve, saphenous nerve, tibial nerve and common peroneal nerve(P<0.05). In addition, the 5-HT and PGE2 levels significantly reduced in both groups postoperatively(P<0.05),which was significantly lower in the endoscopic group than those in the traditional group(P<0.05). [Conclusion] Endoscopic discectomy is effective for lumbar disc herniation, which does effectively improve nerve conduction and downgrade pain mediator levels in this study.更多还原