PLDD治疗腰椎间盘突出症临床分析

2015-03-28张占录,戴兵,张浩等

河北北方学院学报(自然科学版) 2015年1期

PLDD治疗腰椎间盘突出症临床分析

张占录，戴兵，张浩，郝德强，闫秀果

(空军航空医学研究所附属医院外一科二病区，北京 100089)

摘要：目的探讨经皮穿刺激光汽化减压术(percutaneous laser disc decompression,PLDD)治疗包容性腰椎间盘突出症的疗效及其决定因素。方法回顾性分析1 203例采用PLDD治疗的包容性腰椎间盘突出症患者资料。结果916例疼痛消失，无运动功能受限，恢复正常工作和活动；120例偶尔有疼痛，能做简单工作；102例疼痛改善，不能工作；65例有神经根受压表现，需要手术治疗。2例感染，0例神经损伤。术后4～6个月随访，依据MacNab标准判定疗效，优916例，良120例，可102例，差65例，优良率86.12%。结论PLDD治疗包容性腰椎间盘突出症创伤小、疗效好，但应严格掌握适应症，针对腰椎间盘突出症的病因病理机制精确定位，多点低剂量激光汽化突出髓核及肥大增生物。

关键词：退变；损伤；腰椎间盘突出症；经皮穿刺激光汽化减压术

中图分类号：R 681.55

基金项目：河北省教育厅青年基金资助项目(No.SQ132004)；河北北方学院青年基金资助项目(No.Q2013032)

作者简介：温强(1996-)，男，河北阳原人，河北北方学院临床医学本科2014级学生。

Clinical Analysis on the Lumbar Disc Herniation Treat with PLDD

ZHANG Zhan-lu,DAI Bing,ZHANG Hao,et al

(The Affiliated Hospital of the Air Force Aviation Medicine Research Institute,Beijing 100089,China)

Abstract:ObjectiveTo investigate the curative effect and decisive factors of percutaneous laser disc decompression(we will use PLDD as the abbreviation in the following)in treating inclusive lumbar disc herniation.Methods1203 cases of PLDD inclusive lumbar disc herniation cured by orthopedics department of our hospital from May 2011-May 2013 were selected.ResultsThe pain of 916 patients was gone with no limitation of motor function and they could be back to normal work and activities.120 patients had occasional pain but could do some easy work.The pain of 102 patients had been alleviated but not significantly,so they cannot work normally.65 patients showed their nerve was oppressed and need surgery.2 patients were infected.None of them was nerve-injured.Following patients after 4-6 months,the curative effect based on MacNab standards were determined.916 cases were excellent,120 cases were good,102 cases were average and 65 cases were poor.The excellent-good rate was 86.12%.Conclusion indication aiming at the mechanism precise positioning of lumbar disc herniation’s pathogenesis and pathology should be strictly mastered;using Multipoint low-dose laser vaporization to highlight nucleus pulposus and hypertrophy creatures,PLDD cures inclusive lumbar disc herniation with less-injury and good effect.

Key words:regression；injury；umbar disc herniation；percutaneous laser disc decompression

1临床资料

1.1　一般资料

2011-05—2013-05月空军航空医学研究所附属医院共收治腰椎间盘突出症患者1849例，其中脱出型、游离型及合并严重骨性椎管狭窄者348例(18.82%)；包容性(含膨出)腰椎间盘突出症1 501例(81.18%)，通过电话或门诊复查随访成功1 203例，其它298例失访。随访时间术后4~6个月，平均5个月。1 203例中男853例，女350例；年龄18~65岁；病史最短3个月，最长30年。