中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2012年
3期
38-40
,共3页
腰椎间盘突出%激光疗法%减压术%外科
腰椎間盤突齣%激光療法%減壓術%外科
요추간반돌출%격광요법%감압술%외과
Lumbar intervertebral disc hemiation%Laser therapy%Decompression%Surgery
目的 探讨经皮激光椎间盘减压术(PLDD)治疗腰椎间盘突出症治疗效果,分析CT分级(Ⅰ、Ⅱ级)与激光照射量的相关性,研究出相关激光照射量的大小.方法 收集2006年4月至2009年11月合肥市第三人民医院骨科46例腰椎间盘突出症患者,第4～5腰椎间盘突出34例；第5腰椎至第1骶椎和第4～5腰椎同时突出8例；第5腰椎至第1骶椎和第4～5腰椎同时突出并汽化5例.C臂X线机透视下将激光光纤沿穿刺针插入椎间盘髓核中进行汽化.依据CT分级分成CTⅠ级组和CTⅡ级组；每组间激光照射剂量比较采用两样本均数t检验；CT分级为Ⅰ级和Ⅱ级者疗效比较采用X2检验.结果 ①CT分级分成CTⅠ级组和CTⅡ级组,两组间激光照射剂量比较差异有统计学意义(P＜0.05).②CT分级分成CT I级组和CTⅡ级组,两组间治疗效果比较差异无统计学意义(P＞0.05).采用的Macnab标准评定疗效:优31例,良6例,可7例,差2例,优良率为80％.结论 PLDD治疗CTⅠ级组激光照射剂量在500J左右；CTⅡ级组激光照射剂量在600～710 J之间,把握好激光照射量会取得满意的治疗效果.
目的 探討經皮激光椎間盤減壓術(PLDD)治療腰椎間盤突齣癥治療效果,分析CT分級(Ⅰ、Ⅱ級)與激光照射量的相關性,研究齣相關激光照射量的大小.方法 收集2006年4月至2009年11月閤肥市第三人民醫院骨科46例腰椎間盤突齣癥患者,第4～5腰椎間盤突齣34例；第5腰椎至第1骶椎和第4～5腰椎同時突齣8例；第5腰椎至第1骶椎和第4～5腰椎同時突齣併汽化5例.C臂X線機透視下將激光光纖沿穿刺針插入椎間盤髓覈中進行汽化.依據CT分級分成CTⅠ級組和CTⅡ級組；每組間激光照射劑量比較採用兩樣本均數t檢驗；CT分級為Ⅰ級和Ⅱ級者療效比較採用X2檢驗.結果 ①CT分級分成CTⅠ級組和CTⅡ級組,兩組間激光照射劑量比較差異有統計學意義(P＜0.05).②CT分級分成CT I級組和CTⅡ級組,兩組間治療效果比較差異無統計學意義(P＞0.05).採用的Macnab標準評定療效:優31例,良6例,可7例,差2例,優良率為80％.結論 PLDD治療CTⅠ級組激光照射劑量在500J左右；CTⅡ級組激光照射劑量在600～710 J之間,把握好激光照射量會取得滿意的治療效果.
목적 탐토경피격광추간반감압술(PLDD)치료요추간반돌출증치료효과,분석CT분급(Ⅰ、Ⅱ급)여격광조사량적상관성,연구출상관격광조사량적대소.방법 수집2006년4월지2009년11월합비시제삼인민의원골과46례요추간반돌출증환자,제4～5요추간반돌출34례；제5요추지제1저추화제4～5요추동시돌출8례；제5요추지제1저추화제4～5요추동시돌출병기화5례.C비X선궤투시하장격광광섬연천자침삽입추간반수핵중진행기화.의거CT분급분성CTⅠ급조화CTⅡ급조；매조간격광조사제량비교채용량양본균수t검험；CT분급위Ⅰ급화Ⅱ급자료효비교채용X2검험.결과 ①CT분급분성CTⅠ급조화CTⅡ급조,량조간격광조사제량비교차이유통계학의의(P＜0.05).②CT분급분성CT I급조화CTⅡ급조,량조간치료효과비교차이무통계학의의(P＞0.05).채용적Macnab표준평정료효:우31례,량6례,가7례,차2례,우량솔위80％.결론 PLDD치료CTⅠ급조격광조사제량재500J좌우；CTⅡ급조격광조사제량재600～710 J지간,파악호격광조사량회취득만의적치료효과.
Objective To investigate the effect of percutaneous laser disc decompression ( PLDD) on lumbar disc herniation,analyze the relationship between CT classification( Ⅰ,Ⅱ grade)and laser exposure,and develope related size of laser exposure.Methods From April 2006 to November 2009 in third people ' s hospital of hefei,46 cases of lumbar disc herniation were chosen.34 cases of lumbar 4 -5 disc hemiation; 8 cases of lumbar 5 sacral 1 and lumbar 4 t0 5 hemiation,5 cases of lumbar 4 -5 and lumbar 5 sacral I hemiation combined with vaporization.Laser fiber was inserted into the intervertebral disc along the puncture needle to be vaponzed under C-arm X-ray machine.Based on CT grading,the patients were divided inlo CT I group and CT II group ; two sample t test was used to compare doses of laser exposure;X2 test was used to compare the effects of CT grade level of grade I and Ⅱ.Results ①Between CT I grade group and CT Ⅱ grade group,there were significant differences in the laser irradiation dose (P ＜ 0.05 ).②Between CT Ⅰ grade level group and CT Ⅱ level group,there was no significant difference in the treatment effect ( P ＞ 0.05).Assessment of efficacy using the Macnab criteria:excellent in 31 cases,good in 6 cases,fair in 7 cases,poor in 2 cases,the excellent and good rate was 80％.Conclusions The laser irradiation dose of PLDD treatment for CT I level group was around 500J; that of CT II grade group was 600 -710 J; good grasp of the laser exposure dose will achieve a satisfactory therapeutic effect.
