中国冶金工业医学杂志

两种脊柱内镜治疗腰椎侧隐窝狭窄的临床研究*

作者：李小峰冀晶谭自恒周文谢富荣#

单位：广西骨伤医院广西南宁 530012

分类号：R 681

出版年,卷(期):页码：2025,42(5):506-508

摘要：

摘要：目的本研究旨在比较经过Delta大通道（delta large-channel endoscopy，DLE）与椎间孔镜椎板间隙入路（transforaminal endoscopic interlaminar approach，TEIA）两种方法在治疗腰椎侧隐窝狭窄（lumbar lateral recess stenosis，LLRS）中的临床效果。方法本研究选取广西骨伤医院2020年1月—2023年5月收治的LLRS患者60例，使用随机数字表法将患者分为观察组与对照组。观察组（n＝30）接受DLE内镜治疗，对照组（n＝30）接受经TEIA治疗。比较两组的手术时长、术中出血量、住院时间、术后并发症、疼痛视觉模拟评分（VAS）和Oswestry功能障碍指数（ODI）评分，并进行统计分析以评估疗效。结果观察组的手术时间和术中出血量均高于对照组，组间比较差异均有统计学意义（t＝8.461、6.475，均P＜0.05）；两组住院时间相比较，差异无统计学意义（t＝0.564，P＞0.05）。两组在术后1个月及随访各时间段的VAS和ODI评分均显著降低，且观察组评分均低于对照组，组间比较差异均有统计学意义（t＝2.462、4.491、2.675、4.298、5.741、5.194、3.796、4.835，均P＜0.05）。两组术后并发症发生率均为3.33%，差异无统计学意义（P＞0.05）。结论 DLE与TEIA在治疗LLRS方面均有确切的疗效，但是DLE更适合黄韧带肥厚和骨质增生引起的狭窄，而TEIA则更适合椎间盘突出的患者。

Abstract：Objective This study aims to compare the clinical outcomes between two endoscopic of the ?delta large-channel endoscopy（DLE）??and the ?transforaminal endoscopic interlaminar approach（TEIA）??in the treatment of lumbar lateral recess stenosis （LLRS）. Methods A total of 60 patients diagnosed with LLRS admitted to Guangxi Orthopedic Hospital from January 2020 to May 2023 were selected, patients were randomized into observation and control groups using a random number table. The observation group underwent DLE（n＝30）, while the control group received TEIA（n＝30）.The surgical time, intraoperative blood loss, hospital stay duration, postoperative complications, visual analog scale（VAS）scores for pain, and Oswestry disability index（ODI）scores were recorded and compared between groups?, and statistical analyzed to evaluate the efficacy. Results The observation group had significantly longer surgical time and greater intraoperative blood loss compared to the control group?, with? statistically significant difference between groups（t＝8.461、6.475,both P＜0.05）;there was no statistically significant difference in the length of hospital stay between the two groups（t＝0.564, P＞0.05）.The? VAS and ODI scores ?showed significant improvement at 1-month postoperatively and all subsequent follow-up time points ?in both groups?, which in the observation group were lower in the contrast group, with? statistically significant difference between groups（t＝2.462、4.491、2.675、4.298、5.741、5.194、3.796、4.835,all P＜0.05）. The? incidence of postoperative complications was 3.33% ?in each group, ?with? no statistically significant difference between groups（P＞0.05）. Conclusion Both DLE and TEIA are effective in treating LLRS. However the DLE demonstrates more suitable for stenosis ?caused by? ligamentum flavum hypertrophy and ?osteophyte formation?, while the? TEIA is better suited for the cases involving disc herniation.

基金项目：

广西壮族自治区卫生健康委员会自筹经费科研课题（Z20200644）；广西医疗卫生适宜技术开发与推广应用项目（S2021124）

作者简介：

参考文献：

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