中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2014年
22期
5-8
,共4页
椎间盘突出%神经根%激光疗法%减压术%外科
椎間盤突齣%神經根%激光療法%減壓術%外科
추간반돌출%신경근%격광요법%감압술%외과
Intervertebral disc herniation%Nerve root%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的治疗效果,分析CT分级(Ⅰ、Ⅱ级)和临床分度(Ⅰ、Ⅱ、Ⅲ度)与激光照射量的相关性,研究PLDD治疗腰椎间盘突出症适宜的激光照射量.方法 收集2006年4月至2009年11月安徽医科大学合肥第三临床医院骨科46例腰椎间盘突出症患者,其中第4～5腰椎34例;第5腰椎至第1骶椎8例;第4～5腰椎和第1骶椎同时受压4例.依据CT分级分成CT Ⅰ组和CTⅡ级;每组间激光照射剂量比较采用两样本均数t检验;依据临床分度分成Ⅰ、Ⅱ、Ⅲ度,每度为一组,并对46例患者进行激光照射量的统计,每两组间激光照射剂量比较采用SNK-q检验;CT分级为Ⅰ级和Ⅱ级者疗效比较采用x2检验.同时对术后优良率进行统计;术前、术后腰痛及患肢痛VAS评分进行比较.结果 ①CT分级分成CT Ⅰ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).②临床分度分成Ⅰ、Ⅱ、Ⅲ度,每两组间激光照射剂量比较差异无统计学意义(P＞0.05).③CT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).④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％.腰痛及下肢痛VAS评分差异有统计学意义(P＜0.05).结论 PLDD激光照射量CT Ⅰ级组剂量为500 J;CTⅡ级组剂量为600 ～710 J;激光照射剂量大小与临床症状和体征轻重无明显相关,与突出物大小相关;把握好激光照射量能明显改善VAS评分.
目的 探討經皮激光椎間盤減壓術(PLDD)治療腰椎間盤突齣癥的治療效果,分析CT分級(Ⅰ、Ⅱ級)和臨床分度(Ⅰ、Ⅱ、Ⅲ度)與激光照射量的相關性,研究PLDD治療腰椎間盤突齣癥適宜的激光照射量.方法 收集2006年4月至2009年11月安徽醫科大學閤肥第三臨床醫院骨科46例腰椎間盤突齣癥患者,其中第4～5腰椎34例;第5腰椎至第1骶椎8例;第4～5腰椎和第1骶椎同時受壓4例.依據CT分級分成CT Ⅰ組和CTⅡ級;每組間激光照射劑量比較採用兩樣本均數t檢驗;依據臨床分度分成Ⅰ、Ⅱ、Ⅲ度,每度為一組,併對46例患者進行激光照射量的統計,每兩組間激光照射劑量比較採用SNK-q檢驗;CT分級為Ⅰ級和Ⅱ級者療效比較採用x2檢驗.同時對術後優良率進行統計;術前、術後腰痛及患肢痛VAS評分進行比較.結果 ①CT分級分成CT Ⅰ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).②臨床分度分成Ⅰ、Ⅱ、Ⅲ度,每兩組間激光照射劑量比較差異無統計學意義(P＞0.05).③CT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).④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％.腰痛及下肢痛VAS評分差異有統計學意義(P＜0.05).結論 PLDD激光照射量CT Ⅰ級組劑量為500 J;CTⅡ級組劑量為600 ～710 J;激光照射劑量大小與臨床癥狀和體徵輕重無明顯相關,與突齣物大小相關;把握好激光照射量能明顯改善VAS評分.
목적 탐토경피격광추간반감압술(PLDD)치료요추간반돌출증적치료효과,분석CT분급(Ⅰ、Ⅱ급)화림상분도(Ⅰ、Ⅱ、Ⅲ도)여격광조사량적상관성,연구PLDD치료요추간반돌출증괄의적격광조사량.방법 수집2006년4월지2009년11월안휘의과대학합비제삼림상의원골과46례요추간반돌출증환자,기중제4～5요추34례;제5요추지제1저추8례;제4～5요추화제1저추동시수압4례.의거CT분급분성CT Ⅰ조화CTⅡ급;매조간격광조사제량비교채용량양본균수t검험;의거림상분도분성Ⅰ、Ⅱ、Ⅲ도,매도위일조,병대46례환자진행격광조사량적통계,매량조간격광조사제량비교채용SNK-q검험;CT분급위Ⅰ급화Ⅱ급자료효비교채용x2검험.동시대술후우량솔진행통계;술전、술후요통급환지통VAS평분진행비교.결과 ①CT분급분성CT Ⅰ급조화CTⅡ급조,량조간격광조사제량비교차이유통계학의의(P＜0.05).②림상분도분성Ⅰ、Ⅱ、Ⅲ도,매량조간격광조사제량비교차이무통계학의의(P＞0.05).③CT분급분성CT Ⅰ급조화CTⅡ급조,량조간치료효과비교차이무통계학의의(P＞0.05).④채용적Macnab표준평정료효:우31례,량6례,가7례,차2례,우량솔위80％.요통급하지통VAS평분차이유통계학의의(P＜0.05).결론 PLDD격광조사량CT Ⅰ급조제량위500 J;CTⅡ급조제량위600 ～710 J;격광조사제량대소여림상증상화체정경중무명현상관,여돌출물대소상관;파악호격광조사량능명현개선VAS평분.
Objective To study the effect of percutaneous laser disc decompression (PLDD) therapy on lumbar intervertebral disc protrusion,and to analyze the relationship between CT classification (Ⅰ,Ⅱ level) and clinical index (Ⅰ Ⅱ Ⅲ degree) and the appropriate laser irradiation dose.Methods In this hospital,46 patients with lumbar intervertebral disc protrusion were chose from April 2006 to November 2009,34 cases of L4 ～5,8 cases of Ls ～ s1,4 cases of L4～sand S1 at the same time.On the basis of CT results,the patients were divided into CT Ⅰ group and CT Ⅱ group; laser irradiation dose be of each group was compared by two sample mean t test; On the basis of clinical symptul,the patients were divided into Ⅰ,Ⅱ,Ⅲ degree,each in one group,and 46 cases all underwent laser irradiation dose,each laser irradiation dose between the two groups was compared by the SNK-q inspection; resalts of CT classification groups were compared by x2 test.At the same time on postoperative crop statistics; Preoperative and postoperative lumbar pain and limb pain VAS score were compared.Results ①Among CT Ⅰ group and CT Ⅱ group,the laser irradiation dose difference was signifitant (P ＜ 0.05).②Among clinical index groups,each laser irradiation dose has no obvious difference (P ＞ 0.05).③For CT Ⅰ group and CT Ⅱ group,the treatment effect between the two groups had no significant difference (P ＞ 0.05).④USES the Macnab criteria to assess efficacy of:31 cases were excellent,6 cases were good,7 cases were fair,2 cases were poor,and the excellent and good rate was 80％.Lumbago and leg pain VAS score had significant difference (P ＜ 0.05).Conclusions PLDD laser exposure level Ⅰ group CT dose in 500 J; CT Ⅱ group dose level between 600-710J; Laser irradiation dose size was not obvious related with clinical signs and symptoms,but was associated with protrusions size; control good laser exposure can significantly improve the VAS score.
