经皮穿刺腰椎间盘切吸术配合手法治疗腰椎间盘突出症疗效分析  

Comparative analysis of curative effect of auto percutaneous lumbar discectomy (APLD) and APLD with bone setting manipulation for the treatment of lumbar intervertebral disc herniation

作　　者：蔡俊通 张晓莺[2] 许瑞明 李伟居 

机构地区：[1]汕头市中医医院骨科,广东汕头515031 [2]汕头大学第二附属医院

出　　处：《中国骨伤》2006年第8期458-460,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨经皮穿刺腰椎间盘切吸术(APLD)配合手法治疗腰椎间盘突出症的疗效和相关机制。方法:88例腰椎间盘突出症患者分为治疗组和对照组:治疗组48例,男34例,女14例,平均年龄(40·375±13·197)岁;腰痛46例、腰侧弯47例、直腿抬高试验阳性48例;椎间盘突出部位:L3,48个,L4,545个,L5S114个,共67个椎间盘行APLD加手法治疗。对照组40例,男32例,女8例,平均年龄(41·632±11·858)岁;腰痛40例,腰侧弯39例,直腿抬高试验阳性40例;椎间盘突出部位:L3,45个,L4,546个,L5S111个,共62个椎间盘行单纯APLD治疗。观察并比较两组疗效,分析手法对APLD的影响。结果:依据中医病证诊断疗效标准:治疗组48例中手术和手法治疗后即刻症状改善者45例(直腿抬高70°以上),占93·75%;1年后随访,痊愈41例,有效5例,无效2例,有效率95·83%。对照组40例中单纯APLD治疗后即刻症状改善31例,有效率77·50%;1年后随访,痊愈25例,有效8例,无效7例,有效率82·50%。两种治疗方法疗效有显著的统计学意义(P<0·05)。结论:APLD配合手法治疗腰椎间盘突出症具有有效率高、创伤小、恢复快,不干扰椎管内结构,不影响脊柱稳定性,复发率及并发症低,操作简单的优点。Objective： To study the therapeutic effect of auto percutaneous lumbar discectomy （APLD） coordinating with bone setting manipulation for the treatment of lumbar intervertebral disc herniation and the related factors affecting the effect. Methods： Eighty-eight patients of lumbar disc herniation were divided into treatment group and control group. In treatment group, 48 patients included 34 male and 14 female with average age of （40. 375 ± 13. 197） years; Among them there were 46 cases with lumbago, 47 cases with lumbar lateral curvature, 48 cases with the straight leg-raising maneuver test with positive results; The position of lumbar disc herniation were located at L3,4 in 8 cases, L4,5 in 45 cases, L5S1 in 14 cases, altogether 67 cases of lumbar discs were treated with APLD with bone setting manipulation. In control group, 40 patients include 32 male and 8 female with average age of （41. 632 ± 11. 858） years; Among them there were 40 cases with lumbago, 39 cases with lumbar lateral curvature, 40 cases with the straight leg-raising maneuver test with positive results; The position of lumbar disc herniation were located at L3,4 in 5 cases, L4,5 in 46 cases, L5S1 in 11 cases, altogether 62 cases of lumbar discs were treated only with APLD. Observing and comparing the therapeutic effect of two groups, analyzing the related factors to affect the therapeutic effect. Results： According to the therapeutic effect standard, among the treatment group 45 patients were improving instantly after operation and bone setting manipulation （ the straight leg-raising maneuver test more than 70°） , the effective rate was 93.75% ; After a period of 1-year-followed-up, the result was healing in 41 cases,utility in 5, ineffective in 2, the effective rate was 95.83%. Yet among the control group 31 patients were improving instantly after operation （the straight leg-raising maneuver test more than 70°）, the effective rate was 77.50% ; After a period of 1-year-followed-up, the result was healing in 25 cases, u

关 键 词：椎间盘切除术 经皮 椎间盘移位 手法 整骨 

分 类 号：R681.53[医药卫生—骨科学]