青年发生腰椎间盘突出症的流行病学特点及射频消融髓核成形术的疗效分析  

Epidemiological Characteristics of Lumbar Disc Herniation in Young People and the Curative Effect of Radiofrequency Ablation Nucleoplasty

作　　者：王成刚[1] 耿广军 WANG Chenggang;GENG Guangjun(Soft Tissue Injure Treatment Centre Belling Clinical Department of Shenyang Military Region General Hospital,Shenyang 110034,China;Technology Department,Shenyang Traffic Police Detachment)

机构地区：[1]沈阳军区总医院北陵临床部软组织损伤治疗中心,辽宁沈阳110034 [2]沈阳市交警支队事故处

出　　处：《沈阳医学院学报》2018年第6期505-507,共3页Journal of Shenyang Medical College

摘　　要：目的:探究青年发生腰椎间盘突出症(LDH)的流行病学特点并分析射频消融髓核成形术对其的疗效。方法:回顾性分析我院行手术治疗的248例LDH青年患者临床资料,并统计其年龄、性别、职业、体重指数(BMI)以及LDH部位、症状、体征分布情况等流行病学特点;其中行射频消融髓核成形术者113例(观察组),行椎板开窗髓核摘除术(FD)者135例(对照组);比较2组患者临床疗效、术前及术后3个月腰椎功能[魁北克腰痛障碍评分量表(QBPDS)]及生活质量[欧洲五维健康量表问卷调查(EQ-5D)]情况差异。结果:我院248例青年LDH患者以年龄为30～35岁者(74.60%)居多,且男性占比(66.94%)较大;职业以重体力劳动者(47.58%)、长期坐位工作者(42.74%)较常见,BMI多超过25.00 kg/m2(53.23%);LDH部位以L4-5者居多(51.61%);临床症状以腰痛(95.97%)及下肢疼痛(91.53%)为主;体征以棘突旁压痛(81.05%)、直腿抬高阳性(69.35%)为主。观察组疗效及优良率明显高于对照组(P<0.05)。术后3个月时,2组QBPDS、EQ-5D评分均较术前升高(P<0.05),且观察组高于对照组(P<0.05)。结论:青年LDH患者以腰痛、下肢疼痛和棘突旁压痛、直腿抬高阳性为主要临床表现,而肥胖、久坐及重体力工作且年龄较大的男性青年人群更易发生LDH;射频消融髓核成形术对青年LDH患者疗效明显,可改善患者腰椎功能、提高其生活质量,利于患者术后康复。Objective： To investigate the epidemiological characteristics of lumbar disc herniation （LDH） in young people and analyze the curative effect of radiofrequency ablation nucleoplasty. Mehhods ： The clinical data of 248 young patients with LDH in our hospital were retrospectively analyzed. The epidemiological characteristics such as age, gender, occupation, body mass index （BMI） , and the site, symptoms and physical signs of LDH were analyzed. And 113 patients undelavent radiofrequency ablation nucleoplasty （the observation group）, 135 patients underwent fenestration and discectomy （FD） （the control group）. The clinical curative effect, the lumbar vertebral function [Quebec Back Pain Disability Scale （QBPDS） ] and quality of life [EuroQol-5 Dimensions （EQ-5D） ] before surgery and at 3 months after surgery were compared between the two groups. Results： Among the 248 young patients with LDH, the majority were 30-35 years old （74.60%）, and the ratio of male （66.94%） was relatively larger. Heavy workers （47.58%） and long-term sedentary workers （42.74%） were more common. Patients whose BMI 〉25.00 kg/m^2 （53.23%） and patients whose LDH located in L4 s （51.61%） were the majority. Common clinical symptoms mainly included lumbago （95.97%） and lower limb pain （91.53%）. The main physical signs were tenderness beside spinous process （81.05%） and positive straight leg raise （69.35%）. The excellent and good rate of curative effect in the observation group was significantly higher than that in the control group （P〈0.05）. Scores of QBPDS and EQ-5D in the two groups at 3 months after operation were higher than those before operation （P〈0.05）, and the scores were higher in observation group than those in the control group （P〈0.05）. Conclusions： The main clinical manifestations of young patients with LDH include lumbago, lower limb pain, tenderness beside spinous process and positive straight leg raise. Relatively older obese male young pe

关 键 词：腰椎间盘突出症 青年 流行病学 射频消融 髓核成形术 

分 类 号：R687.3[医药卫生—骨科学]