| 张 涛,潘文明,邱 军,汤 愈,黄 开.腰椎间盘突出症患者行经皮内窥镜下腰椎间盘切除术效果及预后影响因素分析[J].现代生物医学进展英文版,2025,(3):488-495. |
| 腰椎间盘突出症患者行经皮内窥镜下腰椎间盘切除术效果及预后影响因素分析 |
| Analysis of the Effects and Prognostic Factors of Percutaneous Endoscopic Lumbar Discectomy in Patients with Lumbar Disc Herniation |
| Received:November 24, 2024 |
| DOI：10.13241/j.cnki.pmb.2025.03.012 |
| 中文关键词: 腰椎间盘突出症 PELD 影响因素 |
| 英文关键词: Lumbar disc herniation PELD Influencing factors |
| 基金项目:2022年度江苏省中西医结合老年病防治重点实验室开放课题（202216） |
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| 中文摘要: |
| 摘要 目的：研究经皮内窥镜下腰椎间盘切除术治疗腰椎间突出症患者效果及预后，并分析影响效果及预后的影响因素。方法：收集2021年1月到2023年11月在我院接受经皮内窥镜下PELD治疗的腰椎间突出症患者86例。根据术后一年随访期间治疗效果及预后评估将分为预后良好组和预后不良组，通过单因素和多因素logistics回归分析法确定影响PELD治疗腰椎间突出症患者效果及预后的因素。结果：89例腰椎间盘突出症患者接受PELD，术后预后良好69例和预后不良17例。单因素和多因素logistics回归分析：Modic改变等级（OR=0.132, 95%CI=0.109-0.715）、Pfirrmann分级（OR=1.232, 95%CI=0.910-1.433）、术后负重劳动（OR=1.372, 95%CI=1.082-1.274）以及术后髓核残留（OR=3.122, 95%CI=2.172-3.192）是PELD治疗效果及预后不良的独立危险因素。结论：PELD治疗腰椎间盘突出症仍有部分治疗效果及预后不佳，其与Modic改变等级和Pfirrmann分级等级较高，术后负重劳动以及手术髓核清除不完整有关。 |
| 英文摘要: |
| ABSTRACT Objective: To study the effect and prognosis of patients with lumbar intervertebral herniation treated by PELD, and to analyze the factors affecting the effect and prognosis. Methods: A total of 86 patients with lumbar intervertebral herniation who underwent PELD in our hospital from January 2021 to November 2023 were enrolled. According to the treatment effect and prognosis evaluation during the one-year follow-up period after surgery, the patients were divided into good prognosis group and poor prognosis group, and the factors affecting the effect and prognosis of patients with lumbar intervertebral herniation were determined by univariate and multivariate logistics regression analysis. Results: 89 patients with lumbar disc herniation underwent PELD, with a good prognosis in 69 cases and a poor prognosis in 17 cases. Results of univariate and multivariate logistics regression analysis showed that Modic grade of change (OR=0.132, 95%CI=0.109-0.715), Pfirrmann grade (OR=1.232, 95% CI=0.910-1.433), postoperative weight-bearing labor (OR=1.372, 95% CI=1.082-1.274), and postoperative nucleus pulposus residue (OR=3.122, 95%CI=2.172-3.192) were independent risk factors for poor efficacy and prognosis of PELD. Conclusion: PELD in the treatment of lumbar disc herniation still has some therapeutic effects and poor prognosis, which is related to the higher grade of Modic change and Pfirrmann grade, postoperative weight-bearing labor, incomplete surgical nucleus pulposus resection. |
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