中医药信息
中醫藥信息
중의약신식
INFORMATION ON TRADITIONAL CHINESE MEDICINE
2015年
4期
119-121
,共3页
张宇%简伟%许学猛%吴少鹏%李参天%邓崇礼%梁灿德%古伟文%朱志华%张浩
張宇%簡偉%許學猛%吳少鵬%李參天%鄧崇禮%樑燦德%古偉文%硃誌華%張浩
장우%간위%허학맹%오소붕%리삼천%산숭례%량찬덕%고위문%주지화%장호
腰椎间盘突出症%椎间孔镜%中药熨敷治疗
腰椎間盤突齣癥%椎間孔鏡%中藥熨敷治療
요추간반돌출증%추간공경%중약의부치료
Lumbar disc herniation%Percutaneous transforaminal endoscopic%TCM ironing treatment
目的：回顾性分析脊柱经皮侧后路椎间孔内镜配以中药熨敷治疗腰椎间盘突出症的方法及临床疗效。方法：2013年10月～2014年3月行腰椎X线正侧位片、过伸过屈动力位片、腰椎计算机断层扫描（ CT）及核磁共振成像（ MRI）辅助诊断18例腰椎间盘突出症患者，在局部麻醉下先行椎间盘造影术明确腰椎间盘突出主要责任节段，明确后行经皮侧后路椎间孔镜髓核摘除术。术后患者腰椎部位全部配合中药外用熨敷治疗。入院和术后随访时对患者腰腿痛进行视觉模拟评分（ VAS）；采用Oswestry功能障碍指数（ ODI）评估腰椎功能。结果：18例患者均成功实施手术，1例术中神经根损伤，无患者转开放手术。随访平均14．2个月。 VAS由术前的平均7．17分下降到末次随访时的2．13分，差异具有统计学意义（ P ＜0．05）；ODI 由术前平均53．15降至末次随访时的21．12。差异具有统计学意义（ P ＜0.05）。结论：经皮脊柱侧后路椎间孔内镜配以中药熨敷治疗腰椎间盘突出症中长期疗效满意，总体安全，并发症少，复发率低。
目的：迴顧性分析脊柱經皮側後路椎間孔內鏡配以中藥熨敷治療腰椎間盤突齣癥的方法及臨床療效。方法：2013年10月～2014年3月行腰椎X線正側位片、過伸過屈動力位片、腰椎計算機斷層掃描（ CT）及覈磁共振成像（ MRI）輔助診斷18例腰椎間盤突齣癥患者，在跼部痳醉下先行椎間盤造影術明確腰椎間盤突齣主要責任節段，明確後行經皮側後路椎間孔鏡髓覈摘除術。術後患者腰椎部位全部配閤中藥外用熨敷治療。入院和術後隨訪時對患者腰腿痛進行視覺模擬評分（ VAS）；採用Oswestry功能障礙指數（ ODI）評估腰椎功能。結果：18例患者均成功實施手術，1例術中神經根損傷，無患者轉開放手術。隨訪平均14．2箇月。 VAS由術前的平均7．17分下降到末次隨訪時的2．13分，差異具有統計學意義（ P ＜0．05）；ODI 由術前平均53．15降至末次隨訪時的21．12。差異具有統計學意義（ P ＜0.05）。結論：經皮脊柱側後路椎間孔內鏡配以中藥熨敷治療腰椎間盤突齣癥中長期療效滿意，總體安全，併髮癥少，複髮率低。
목적：회고성분석척주경피측후로추간공내경배이중약의부치료요추간반돌출증적방법급림상료효。방법：2013년10월～2014년3월행요추X선정측위편、과신과굴동력위편、요추계산궤단층소묘（ CT）급핵자공진성상（ MRI）보조진단18례요추간반돌출증환자，재국부마취하선행추간반조영술명학요추간반돌출주요책임절단，명학후행경피측후로추간공경수핵적제술。술후환자요추부위전부배합중약외용의부치료。입원화술후수방시대환자요퇴통진행시각모의평분（ VAS）；채용Oswestry공능장애지수（ ODI）평고요추공능。결과：18례환자균성공실시수술，1례술중신경근손상，무환자전개방수술。수방평균14．2개월。 VAS유술전적평균7．17분하강도말차수방시적2．13분，차이구유통계학의의（ P ＜0．05）；ODI 유술전평균53．15강지말차수방시적21．12。차이구유통계학의의（ P ＜0.05）。결론：경피척주측후로추간공내경배이중약의부치료요추간반돌출증중장기료효만의，총체안전，병발증소，복발솔저。
Objective:To conduct a retrospective analysis of diagnosis and treatment of lumbar disc herniation by percutaneous transforaminal endoscopic lumbar discectomy( PELD) and traditional Chinese medicine( TCM) i-roning treatment.Methods:From October 2013 to March 2014, 18 patients with lumbar disc herniation under-went PELD under local anesthesia.The patients were treated by TCM ironing treatment in post-operation.All patients underwent lumbar radiography, computed tomography(CT)and magnetic resonance imaging(MRI). The primary responsible spinal level was treated by PELD.The preoperative and postoperative visual analogue scale( VAS) was used to evaluate the sciatica and/or back pain.The outcomes were evaluated by Oswestry dis-ability index( ODI) .Results:18 cases had the surgery performed successfully.One patient had nerve root in-jury complicated with paraestllesia and weakness of the affected lower extremity and was relieved gradually af-ter conservative treatment for over 3 months.No one had a conversion into open surgery.They were followed up for a mean period of 14.2 months.VAS was improved significantly from preoperative 7.17 to postoperative 2.13(P<0.05).ODI was decreased from preoperative 53.15 to 21.12 at the last follow-up(P<0.05). Conclusion:With fewer complications and a low recurrence rate,percutaneous transforaminal endoscopic lum-bar discectomy with TCM ironing treatment is safe and efficacious in the treatment of lumbar disc herniation.
