CAJ | 학술논문

目的　探讨经皮穿刺腰椎间盘激光汽化减压术（PLDD）的临床应用价值。方法　腰椎间盘突出症患者121例，椎间盘突出133个。透视下将波长为 810 nm半导体激光光纤顺穿刺针插入病变椎间盘髓核中进行汽化，汽化过程中行负压抽吸。激光参数：功率15 W、脉冲时间1.0 s、间隔时间1.0 s、汽化总能量1 200～1 600 J。121例术后1个月和6个月各随访1次，其中26例术后13～18个月随访1次。结果　121例133个椎间盘突出，症状和体征完全缓解率为73.6%，症状和体征改善率23.1%，无效3.3%，术后再穿刺率为5.8%，术后外科手术率为4.1%，术中术后未发生严重并发症。结论　PLDD是一种安全、简单、有效的治疗椎间盘突出的介入手术方法，是传统手术的有效补充。
목적　탐토경피천자요추간반격광기화감압술（PLDD）적림상응용개치。 방법　요추간반돌출증환자121례，추간반돌출133개。투시하장파장위 810 nm반도체격광광섬순천자침삽입병변추간반수핵중진행기화，기화과정중행부압추흡。 격광삼수：공솔15 W、맥충시간1.0 s、간격시간1.0 s、기화총능량1 200～1 600 J。121례술후1개월화6개월각수방1차，기중26례술 후13～18개월수방1차。 결과　121례133개추간반돌출，증상화체정완전완해솔위73.6%，증상화체정 개선솔23.1%，무효3.3%，술후재천자솔위5.8%，술후외과수술솔위4.1%，술중술후미 발생엄중병발증。 결론　PLDD시일충안전、간단、유효적치료추 간반돌출적개입수술방법，시전통수술적유효보충。
Objective　To evaluate the clinical value of percutaneous laser disc decompression (PLDD). Methods　133 discs in 121 cases of lumbar intervertebral disc herniat ion were treated with PLDD. Under guidance of x-ray fluoroscopoy a needle was pu nctured into the lumbar disc and then the laser fiber was introduced int o the disc center through needle tube. The semiconductor laser with 810 nm wavel ength was used to perform the process of disc evaporating decompression. During the process, the gas was aspirated from the disc continually. The treated laser power was 15 W, the pulse time was 1.0 s and the total treated energy was 1 200-1 600 J. All the patients were followed u p at 1 and 6 months after operation. Among these patients, 26 were further follo wed up at 13-18 months after operation. Results　Of the 121 cases treated by PLDD, 89 cases (73.6%) were cur ed with no symptoms and signs, 28 cases (23.1%) improved and 4 cases (3.3%) no effective. The repuncture rate was 5.8% and surgical operation was made on 5 cases (4.1%) after PLDD. Serious complication did not happen during and after t he operation. Conclusions　PLDD is a safe and effective interventional therapy to lumbar intervertebral disc herniation and a valuable supplement to surgica l operation.