[1]齐昊,顾运涛,付昆.基于MRI影像学及创伤应激指标评价UBE与PELD治疗腰椎间盘突出症的临床效果[J].陕西医学杂志,2025,54(12):1672-1677.[doi:DOI:10.3969/j.issn.1000-7377.2025.12.014]
　QI Hao,GU Yuntao,FU Kun.Clinical efficacy of UBE and PELD in treatment of LDH based on MRI imaging and trauma stress indicators[J].,2025,54(12):1672-1677.[doi:DOI:10.3969/j.issn.1000-7377.2025.12.014]
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基于MRI影像学及创伤应激指标评价UBE与PELD治疗腰椎间盘突出症的临床效果

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
54
期数:
2025年12期
页码:
1672-1677
栏目:
临床研究
出版日期:
2025-12-05

文章信息/Info

Title:
Clinical efficacy of UBE and PELD in treatment of LDH based on MRI imaging and trauma stress indicators
作者:
齐昊1; 顾运涛1; 付昆2
（1.海南医科大学第二附属医院脊柱外科，海南 海口 570100；2.海南医科大学第一附属医院骨科，海南 海口 570100）
Author(s):
QI Hao1; GU Yuntao1; FU Kun2
(1.Department of Spinal Surgery,the Second Affiliated Hospital of Hainan Medical University,Haikou 570100,China;2.Department of Orthopedics,the First Affiliated Hospital of Hainan Medical University,Haikou 570100,China)
关键词:
腰椎间盘突出症; 磁共振成像; 创伤应激反应; 单侧双通道内镜技术; 经皮椎间孔脊柱内镜技术
Keywords:
Lumbar disc herniation; Magnetic resonance imaging; Traumatic stress response; UBE; PELD
分类号:
R 687.3
DOI:
DOI:10.3969/j.issn.1000-7377.2025.12.014
文献标志码:
A
摘要:
目的：基于磁共振成像（MRI）影像学及创伤应激指标评价单侧双通道内镜技术（UBE）与经皮椎间孔脊柱内镜技术（PELD）治疗腰椎间盘突出症（LDH）的临床效果。方法：采用随机数字表法将94例LDH患者随机分为UBE组和PELD组，各47例，分别给予UBE和PELD治疗。比较两组优良率、围手术期指标、视觉模拟量表（VAS）评分与Oswestry功能障碍指数（ODI）评分、创伤应激指标[肌酸激酶（CK）、白细胞介素-6（IL-6）、C-反应蛋白（CRP）]、影像学结果以及并发症。结果：术后12个月，两组优良率分别为89.36%、87.23%，组间比较无统计学差异（P>0.05）。UBE组术中出血量较PELD组高，术中透视次数较PELD组少（均P＜0.05）。术后1、3、12个月，两组VAS、ODI评分降低（均P＜0.05）。术后1 d，两组血清CK、IL-6、CRP水平高于术前，且UBE组高于PELD组（均P＜0.05）。术后3 d，两组血清CK、IL-6、CRP水平低于术后1 d（均P＜0.05），与术前比较无统计学差异（均P>0.05）。术后12个月，两组硬膜囊面积较术前增加，且UBE组硬膜囊面积较PELD组更大（均P＜0.05）。结论：UBE与PELD均可有效缓解LDH患者疼痛，改善腰椎功能。UBE术中透视次数少，硬膜囊面积改善更优。PELD更具微创优势。
Abstract:
Objective:To investigate the clinical efficacy of unilateral biportal endoscopy (UBE) and percutaneous endoscopic lumbar discectomy (PELD) in the treatment of lumbar disc herniation (LDH) based on magnetic resonance imaging (MRI) findings and traumatic stress indicators.Methods：A total of 94 patients with LDH were randomly divided into the UBE group and the PELD group by random number table method,with 47 cases in each group.UBE and PELD were respectively administered to the two groups.The excellent and good rate,perioperative indicators,VAS score and ODI score,trauma stress indicators (CK,IL-6,CRP),imaging results and complications were compared between the two groups.Results:At 12 months after surgery,the excellent and good rates of the two groups were 89.36% and 87.23% respectively,and the two groups was not different (P>0.05).Compared with the PELD group,the intraoperative blood loss was higher and the number of intraoperative fluoroscopies was lower in the UBE group (all P<0.05).At 1,3,and 12 months after surgery,the VAS and ODI scores of both groups decreased (both P<0.05).On the 1st day after surgery,the serum CK,IL-6,and CRP levels of both groups were higher than those before surgery,and the UBE group was higher than the PELD group (all P<0.05).On the 3rd day after surgery,the serum CK,IL-6,and CRP levels of both groups were lower than those on the 1st day (all P<0.05),and there was no statistically significant difference compared with those before surgery (all P>0.05).At 12 months after surgery,the area of the dural sac in both groups increased compared with that before surgery,and the dural sac area in the UBE group was larger than that in the PELD group (all P<0.05).Conclusion:Both UBE and PELD can effectively relieve pain and improve lumbar function in patients with LDH.UBE is associated with fewer intraoperative fluoroscopies and better improvement in dural sac area,while PELD has more advantages in minimal invasiveness.

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备注/Memo

备注/Memo:
海南省卫生健康行业科研项目（20A200465）
更新日期/Last Update: 2025-12-05