经皮激光腰椎间盘减压术激光照射量与CT分级相关性研究  

Correlation study of laser exposure in percutaneous laser lumbar disc decompression and CT classification

作　　者：付昌马[1] 杨祖华[1] 

机构地区：[1]安徽省合肥市第三人民医院骨科,230022

出　　处：《中国实用医刊》2012年第3期38-40,共3页Chinese Journal of Practical Medicine

基　　金：合肥市科技局重点科研项目（2007-1013）

摘　　要：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X^2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CTⅠ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600～710J之间，把握好激光照射量会取得满意的治疗效果。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 herniation ; 8 cases of lumbar 5 sacral 1 and lumbar 4 to 5 herniation, 5 cases of lumbar 4 - 5 and lumbar 5 sacral 1 herniation combined with vaporization. Laser fiber was inserted into the intervertebral disc along the puncture needle to be vaporized under C-arm X-ray machine. Based on CT grading, the patients were divided into 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. ①Results Between CT I grade group and CT 1I grade group, there were significant differences in the laser irradiation dose （P 〈 0. 05 ）. ②Between CT Ⅰgrade 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.

关 键 词：腰椎间盘突出 激光疗法 减压术 外科 

分 类 号：R816.8[医药卫生—放射医学]