中国医药导刊
中國醫藥導刊
중국의약도간
CHINESE JOURNAL OF MEDICAL GUIDE
2013年
8期
1368-1371
,共4页
腰椎间盘突出症%无创与微创治疗%综述
腰椎間盤突齣癥%無創與微創治療%綜述
요추간반돌출증%무창여미창치료%종술
Lumbar disc herniation%Non-invasive and minimally invasive treatment%Summary
目的：腰椎间盘突出症是临床常见骨科疾病，临床上治疗方法主要包括三种：无创、微创与手术治疗。本文通过对近5年医学界对腰椎间盘突出症的无创与微创治疗的文献进行综述与分析，了解目前无创与微创治疗的临床研究与进展。方法：目前无创治疗方面治疗主要包括：卧床休息；药物疗法；针灸推拿；牵引术、综合疗法等。微创治疗腰椎间盘突出症的方法主要包括以下几种：经皮穿刺椎间盘切除或汽化术；臭氧介入治疗；射频消融治疗；显微外科椎间盘切除术；显微内镜椎间盘切除术。现对腰椎间盘突出症无创、微创治疗两方面进行综述与分析。结果：微创治疗创伤小，不容易破坏脊柱稳定性。牵引治疗能调整脊柱生理曲度，纠正脊柱畸形，但不能减少髓核组织和降低椎间盘压力。微创经皮穿刺腰椎间盘汽化术治疗降低椎间盘压力，但不能纠正脊柱关节紊乱和畸形，调整脊柱生理曲度。结论：综合无创与微创技术在治疗腰椎间盘突出症的应用，两者均具有操作方便、创伤小、出血少、并发症少、对腰椎稳定性影响小等优点；随着医学科学的发展，无创与微创治疗的相互结合，取长补短，将是临床医学研究的新方向之一，用最小的代价解除患者的疼痛是我们的最终治疗目的。
目的：腰椎間盤突齣癥是臨床常見骨科疾病，臨床上治療方法主要包括三種：無創、微創與手術治療。本文通過對近5年醫學界對腰椎間盤突齣癥的無創與微創治療的文獻進行綜述與分析，瞭解目前無創與微創治療的臨床研究與進展。方法：目前無創治療方麵治療主要包括：臥床休息；藥物療法；針灸推拿；牽引術、綜閤療法等。微創治療腰椎間盤突齣癥的方法主要包括以下幾種：經皮穿刺椎間盤切除或汽化術；臭氧介入治療；射頻消融治療；顯微外科椎間盤切除術；顯微內鏡椎間盤切除術。現對腰椎間盤突齣癥無創、微創治療兩方麵進行綜述與分析。結果：微創治療創傷小，不容易破壞脊柱穩定性。牽引治療能調整脊柱生理麯度，糾正脊柱畸形，但不能減少髓覈組織和降低椎間盤壓力。微創經皮穿刺腰椎間盤汽化術治療降低椎間盤壓力，但不能糾正脊柱關節紊亂和畸形，調整脊柱生理麯度。結論：綜閤無創與微創技術在治療腰椎間盤突齣癥的應用，兩者均具有操作方便、創傷小、齣血少、併髮癥少、對腰椎穩定性影響小等優點；隨著醫學科學的髮展，無創與微創治療的相互結閤，取長補短，將是臨床醫學研究的新方嚮之一，用最小的代價解除患者的疼痛是我們的最終治療目的。
목적：요추간반돌출증시림상상견골과질병，림상상치료방법주요포괄삼충：무창、미창여수술치료。본문통과대근5년의학계대요추간반돌출증적무창여미창치료적문헌진행종술여분석，료해목전무창여미창치료적림상연구여진전。방법：목전무창치료방면치료주요포괄：와상휴식；약물요법；침구추나；견인술、종합요법등。미창치료요추간반돌출증적방법주요포괄이하궤충：경피천자추간반절제혹기화술；취양개입치료；사빈소융치료；현미외과추간반절제술；현미내경추간반절제술。현대요추간반돌출증무창、미창치료량방면진행종술여분석。결과：미창치료창상소，불용역파배척주은정성。견인치료능조정척주생리곡도，규정척주기형，단불능감소수핵조직화강저추간반압력。미창경피천자요추간반기화술치료강저추간반압력，단불능규정척주관절문란화기형，조정척주생리곡도。결론：종합무창여미창기술재치료요추간반돌출증적응용，량자균구유조작방편、창상소、출혈소、병발증소、대요추은정성영향소등우점；수착의학과학적발전，무창여미창치료적상호결합，취장보단，장시림상의학연구적신방향지일，용최소적대개해제환자적동통시아문적최종치료목적。
Objective:Lumbar disc herniation is a common clinical orthopedic diseases, clinical treatment method mainly includes three types: non-invasive, minimally invasive and surgical treatment. To understand the current clinical research and progress of non-invasive and minimally invasive treatment for lumbar disc herniation, we designed this literature review and analysis based on the past five years. Methods:Currently for lumbar disc herniation, the non-invasive treatment methods include:bed rest;drug therapy;acupuncture;traction, comprehensive therapy. Minimally invasive treatment methods include: percutaneous discectomy or vaporization; ozone intervention;radiofrequency ablation;microsurgical discectomy;endomicroscopy discectomy. The noninvasive and minimally invasive treatment were reviewed and analyzed. Results:For minimally invasive treatment, the trauma is minimal, and the spinal stability is not easy to be destroyed. Traction therapy can adjust the spine lordosis, correct spinal deformity, but can not reduce the nucleus pulposus and reduce disc pressure. Minimally invasive percutaneous lumbar intervertebral disc vaporization therapy reduces stress, but can not correct spinal disorders and joint deformities, adjusting the spine lordosis. Conclusion:Integrated non-invasive and minimally invasive techniques in the treatment of lumbar disc herniation applications, both with easy operation, minimal trauma, less bleeding, fewer complications, little effect on the stability of the lumbar spine, etc. With the development of medical science, noninvasive and minimally invasive treatment combined with each other, learn from each other, will be the new direction of clinical research. With the minimum cost relieve the patient’s pain is our ultimate therapeutic purposes.
