椎间盘镜下钬激光联合灯盏细辛硬膜外注射治疗腰椎间盘突出症  

Micro Endoscopy Discectomy with Ho:YAG Laser and Dengzhanxixin Injectionin the Treatment of Lumbar Disc Herniation

作　　者：陈滨[1] 张闽光[1] 冯宇[1] 

机构地区：[1]上海中医药大学附属市中医医院放射科,上海200071

出　　处：《应用激光》2016年第6期774-776,共3页Applied Laser

摘　　要：目的：探讨椎间盘镜下钬激光联合灯盏细辛注射液硬膜外注射治疗腰椎间盘突出症的临床应用价值。方法：采用前瞻性队列研究,将2015年1月~2015年10月间行椎间盘镜下钬激光联合灯盏细辛硬膜外注射治疗腰椎间盘突出症的共48例患者纳入研究。采用Joimax椎间盘镜系统和Lumenis脉冲式钬激光。经椎间盘镜行后路椎板减压,钬激光光纤导入病变椎间隙,对髓核组织进行汽化,并且将灯盏细辛注射液行硬膜外注射。采用ODI评分评估临床疗效,术后3个月、1年分别门诊随访。结果：所有病例无并发症,无腰腿痛复发,ODI评分术前（52.12±3.84）分,术后3月的（24.22±4.61）分,术后1年的（23.58±2.98）分。术后3个月以及1年与术前相比,ODI评分均有统计学差异（P〈0.05）。结论：椎间盘镜技术与钬激光应用的结合,手术创伤小,是一种微创治疗腰椎间盘突出症安全且行之有效的方法,术中联合灯盏细辛硬膜外注射,可迅速减轻硬膜外腔炎性水肿,提高手术疗效和手术耐受性。Objectives：To evaluate the clinical effect of micro endoscopy discectomy with holmium laser in the treatment of lum- bar disc herniation. Methods：Prospective cohort study. 48 patients diagnosed with lumbar disc hernia in our hospital from Jan 2015 to Oct 2015, were treated with micro endoscopy discectomy and holmium laser using Joimax system and Lumenis Ho： YAG laser system. The micro endoscopy system was inserted into the lamina through an operational channel to release the nerve root. Ho：YAG laser fiber was inserted into the inververtebraI disc space inducing the vaporization of nucleus pulposus tissue, along with the epidural injection of Dengzhanxixin. ODI scores were evaluated at 3 months and 1 year follow up, re- spectively. Results：No perioperative complications or lumbar herniation recurrence were found in our patients. ODI score： pre- operative （12.86±2.19） ; 3 months post operation （25.14±1.35） ; and 1 year postop （24.73±.12） , （P〈0.05）. Conclu- sions ： MED discectomy combined with H laser application technology is a minimal-invasive technology for the treatment of lum bar disc herniation with complete nerve root decompression, no disturbance of the stability of the spine. Intraoperative epidural injecetion of Dengzhanxixin can further improve the edema of nerve root and contribute to a rapid postoperative recovery.

关 键 词：钬激光 椎间盘镜 灯盏细辛注射液 腰椎间盘突出 

分 类 号：R289.6[医药卫生—方剂学] TN249[医药卫生—中药学]