经皮激光椎间盘汽化减压术联合腰椎牵引疗法治疗腰椎间盘突出症的疗效观察  

Outcomes to Treat Lumbar Disc Herniation Jointly with Percutaneous Laser Disc Decompression and Lumbar Traction

作　　者：朱宝[1] 赵继荣[1] 朱换平[1] 赵宁[2] 

机构地区：[1]甘肃中医药大学,兰州市730000 [2]甘肃省中医院

出　　处：《中国激光医学杂志》2016年第4期196-200,共5页Chinese Journal of Laser Medicine & Surgery

摘　　要：目的观察经皮激光椎间盘汽化减压术(percutaneous laser disc decompression,PLDD)联合腰椎牵引疗法治疗腰椎间盘突出症(lumbar discherniation,LDH)的疗效。方法 LDH患者58例,按随机数字表法随机分为治疗组和对照组,每组患者29例,治疗组给予PLDD联合腰椎牵引疗法;对照组给予单纯的PLDD治疗,所有患者于术前、术后7 d,1、3、6和12个月,采用Oswestry功能障碍指数问卷表(oswestry disability index,ODI)和视觉模拟疼痛评分法(visual analogue scale,VAS)进行腰椎功能及疼痛评估,术后12个月采用改良MacNab疗效标准评价临床疗效。结果两组患者术前和术后12个月ODI功能障碍指数和VAS疼痛评分比较,差异无统计学意义(P>0.05)。治疗组患者术后7 d,1、3和6个月的ODI功能障碍指数较对照组降低(P<0.05);疼痛较对照组缓解明显(P<0.05),组内术后不同时间点的ODI功能障碍指数及VAS疼痛评分与术前比较,均明显减低(P<0.05)。两组患者在术后7 d疼痛都明显改善,但VAS疼痛评分比较,差异无统计学意义(P>0.05)。术后随访12个月改良MacNab疗效评价,治疗组优良率93.10%,有效率100.0%;对照组优良率82.8%,有效率96.6%;两组优良率和有效率比较,差异无统计学意义(P>0.05)。结论远期疗效相比,两种治疗方案在改善腰椎功能和缓解患者疼痛方面,都有良好的治疗效果,且差异无统计学意义;但PLDD治疗后,给予腰椎牵引疗法,能在早期更好地促进突出椎间盘的还纳,尽早改善腰椎功能和缓解患者疼痛。Objective To observe the joint therapeutic effect of percutaneous laser disc decompression （PLDD） and lumbar traction on lumbar disc herniation （LDH）. Methods Totally 58 qualified patients of LDH were randomly divided into the treatment group and control group. While the patients in the control group taking sole PLDD treatment, those in the treatment group were given PLDD plus lumbar traction treatment. Lumbar function and pain evaluation was performed for all the patients before the operation and 7 days, l month, 3 months, 6 months andl2 months after the operation respectively with Oswestry dysfunction index （ODI） and Visual analogue scale （VAS）. The clinically curative effect of all these patients was evaluated with modified MacNab curative effect standards 12 months after the operation. Results The differences＇between the two groups were not significant （P 〉 0. 05） in ODI dysfunction index and VAS pain score before the operation and 12 months after the operation. The degrees of lumbar disorder and pain suffered by the patients of the two groups were similar. Compared with those in the control group, the patients in the treatment group had remarkably lower（P 〈 0.05 ） ODI dysfunction indexes 7 days, 1 month, 3 months and 6 months after the operation. For both groups, the pain suffered by the patients eased obviously 7 days after the operation, and the difference between the two groups in VAS pain score was not significant （P 〉 0.05 ）. Compared with that of the control group, the pain of the patients in the treatment group eased remarkably （ P 〈 0.05 ） 1 month, 3 months and 6 months after the operation. For both groups, the ODI dysfunction index and VAS pain score dropped after the operation and the differences were statistically significant （P 〈 O. 05）. The curative effect of the patients of both groups was evaluated with modified MacNab curative effect evaluation standards and compared when the 12 month follow-up was carried out. The excellent rate and effective r

关 键 词：经皮激光椎间盘汽化减压术 腰椎间盘突出症 腰椎牵引疗法 

分 类 号：R687.3[医药卫生—骨科学]