[1]孙亚东△,周秋兰,鲁会肖.单侧双通道内镜技术与常规经皮内窥镜腰椎间盘切除术治疗腰椎管狭窄症的疗效比较[J].中国中医骨伤科杂志,2025,33(10):34-38.[doi:10.20085/j.cnki.issn1005-0205.251007]
　SUN Yadong,ZHOU Qiulan,LU Huixiao.Comparison of Unilateral Dual-Channel Endoscopic Technique and Conventional Percutaneous Endoscopic Lumbar Discectomy in the Treatment of Lumbar Spinal Stenosis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(10):34-38.[doi:10.20085/j.cnki.issn1005-0205.251007]
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单侧双通道内镜技术与常规经皮内窥镜腰椎间盘切除术治疗腰椎管狭窄症的疗效比较()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年10期
页码:
34-38
栏目:
临床研究
出版日期:
2025-10-15

文章信息/Info

Title:
Comparison of Unilateral Dual-Channel Endoscopic Technique and Conventional Percutaneous Endoscopic Lumbar Discectomy in the Treatment of Lumbar Spinal Stenosis
文章编号:
1005-0205(2025)10-0034-05
作者:
孙亚东1△; 周秋兰1; 鲁会肖1
1华北医疗健康集团邢台总医院(河北 邢台,054000)
Author(s):
SUN Yadong1△; ZHOU Qiulan1; LU Huixiao1
1North China Healthcare Group Xingtai General Hospital,Xingtai 054000,Hebei China.
关键词:
腰椎管狭窄症;  单侧双通道内镜技术;  经皮内窥镜腰椎间盘切除术;  高迁移率族蛋白B1(HMGB1);  单核细胞趋化蛋白-1(MCP-1);  白细胞介素-1α(IL-1α)
Keywords:
lumbar spinal stenosis;  unilateral double-channel endoscopic technique;  percutaneous endoscopic lumbar discectomy;  high mobility group protein B1(HMGB1);  monocyte chemoattractant protein-1(MCP-1);  interleukin-1α(IL-1α )
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.251007
文献标志码:
A
摘要:
目的:比较单侧双通道内镜技术(UBE)与常规经皮内窥镜腰椎间盘切除术(PELD)治疗腰椎管狭窄症(LSS)的疗效。方法:将2022年1月至2024年6月收治的102例腰椎管狭窄症患者分为采用常规经皮内窥镜腰椎间盘切除术治疗的组Ⅰ(49例)和采用单侧双通道内镜技术治疗的组Ⅱ(53例),所有患者术后均随访6个月,随访期间无失访病例。统计两组患者随访6个月后MacNab标准疗效及术后住院期间并发症发生情况; 比较两组患者围术期指标、术前和术后5 d血清细胞因子水平、术前及术后1个月和6个月视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评分、硬膜囊横截面积。结果:术后6个月,组Ⅱ和组Ⅰ总有效率差异无统计学意义(P>0.05),组Ⅱ围术期指标均优于组Ⅰ(P<0.05)。与术前比较,两组患者术后5 d血清高迁移率族蛋白B1(HMGB1)、单核细胞趋化蛋白-1(MCP-1)、白细胞介素-1α(IL-1α)水平均降低,组Ⅱ低于组Ⅰ,差异有统计学意义(P<0.05)。两组患者术前及术后1个月和6个月,VAS评分、ODI评分均呈降低趋势,组Ⅱ术后1个月和6个月低于组Ⅰ,差异有统计学意义(P<0.05); 硬膜囊横截面积呈升高趋势,组Ⅱ术后1个月和6个月高于组Ⅰ,差异有统计学意义(P<0.05)。术后住院期间,组Ⅱ和组Ⅰ总并发症发生率差异无统计学意义(P>0.05)。结论:采用常规经皮内窥镜腰椎间盘切除术和单侧双通道内镜技术对腰椎管狭窄症患者进行治疗均能取得良好的疗效,且术后并发症均较少,但单侧双通道内镜技术手术时间更短,术后恢复更快,且可明显降低患者术后机体炎症反应,缓解其疼痛,可促进腰椎功能和硬膜囊横截面积恢复。
Abstract:
Objective:To compare the efficacy of unilateral double-channel endoscopic technique(UBE)and conventional percutaneous endoscopic lumbar discectomy(PELD)in the treatment of lumbar spinal stenosis(LSS).Methods:A total of 102 patients with LSS from January 2022 to June 2024 were selected as the research objects.According to the different surgical methods,they were divided into the groupⅠ(49 cases)treated with conventional PELD and the groupⅡ(53 cases)treated with UBE.All patients were followed up for 6 months after operation,and no cases were lost during the follow-up period.The efficacy of MacNab after 6 months of follow-up and the incidence of complications during postoperative hospitalization were counted in the groupⅠ and the groupⅡ.Perioperative indicators,serum cytokine levels before and 5 d after surgery,scores of visual analogue scale(VAS),Oswestry dysfunction index(ODI),and dural sac cross-sectional area before and 1 and 6 months after surgery were compared between the groupⅠ and the groupⅡ.Results:At 6 months after operation,there was no significant difference in the total effective rate between the groupⅡ and the groupⅠ(P>0.05).The perioperative indexes of the dual-channel group were better than those of the groupⅠ(P<0.05).Compared with before operation,the levels of serum high mobility group protein B1(HMGB1),monocyte chemoattractant protein-1(MCP-1)and interleukin-1α(IL-1α)in the groupⅠ and the groupⅡ decreased at 5 d after operation,and those in the groupⅡ were lower than the groupⅠ(P<0.05).The scores of VAS and ODI of the groupⅠ and the groupⅡ showed a decreasing trend before and 1 and 6 months after operation,and the groupⅡ was lower than the groupⅠ at 1 and 6 months after operation(P<0.05).The cross-sectional area of the dural sac showed an increasing trend,and the groupⅡ was higher than the groupⅠ at 1 and 6 months after operation(P<0.05).There was no significant difference in the incidence of total complications between the group Ⅱ and the groupⅠduring postoperative hospitalization(P>0.05).Conclusion:Both conventional PELD and UBE could achieve good results in the treatment of patients with LSS,and the postoperative complications are less.However,the UBE operation time is shorter,and faster postoperative recovery.It could effectively reduce the postoperative inflammatory response of patients,relieve their pain,and promote the recovery of lumbar function and dural sac cross-sectional area.

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(收稿日期:2025-06-25)

备注/Memo

备注/Memo:
基金项目:邢台市重点研发计划自筹项目(2023ZC150)
△通信作者 E-mail:sunyadong886@163.com
更新日期/Last Update: 2025-10-10