经皮单点与双点穿刺激光气化减压术治疗腰椎间盘突出症的疗效对比  

Comparison of the Curative Effect of Percutaneous Single-point and Double-point Penetration Stimulation Phosgenation Decompression for Lumbar Disc Herniation

作　　者：赵继荣[1] 张天龙 陈祁青[2] 赵宁[2] 朱宝[2] 马同 薛旭 蔡毅 Zhao Jirong;Zhang Tianlong;Chen Qiqing;Zhao Ning;Zhu Bao;Ma Tong;Xue Xu;Cai Yi(Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou,Gansu 730050,China;Gansu University of Traditional Chinese Medicine,Lanzhou,Gansu 730050,China)

机构地区：[1]甘肃省中医院,甘肃兰州730050 [2]甘肃中医药大学,甘肃兰州730030

出　　处：《应用激光》2021年第4期923-929,共7页Applied Laser

基　　金：2019国家中国医药管理局“中医药循证能力建设项目”(2019xzzx-gk005);国家中医药管理局“陇中正骨学术流派传承工作室”建设项目(No.LP0128061);国家自然科学基金(81760877);兰州市创新人才项目(2018-RC-99);甘肃省自然科学基金项目(17JR5RA051);甘肃省中医药管理局博士基金启动项目(GZK-2018-35)。

摘　　要：为观察经皮穿刺激光气化减压术(percutaneous laser disc decompression, PLDD)单点气化与双点气化治疗腰椎间盘突出症患者的临床疗效,纳入腰椎间盘突出症患者82例,采用随机数字表法将其分为两组,A组单点气化组41例,B组双点气化组41例,两组患者均在局部麻醉下经"C"形臂引导行经皮穿刺激光气化减压术,并连接测压仪,进行压力测定,比较椎间盘内压力差异,采用MacNab、VAS、ODI评分评价临床疗效。结果显示:所有患者均在局麻下顺利完成PLDD,并完成随访,两组患者术前术后腰椎间盘内压力有显著变化,有统计学意义(P<0.05),术前术后压力差平均为(5.2±1.6) mmHg,但A组和B组之间腰椎间盘内压力变化无统计学意义(P>0.05);两组患者术前与术后随访评估结果显示,A组患者的优良率为92.7%,B组患者的优良率为90.2%,总的优良率为91.5%,总有效率为97.6%,两组间优良率和有效率比较,差异无统计学意义(P>0.05);两组患者治疗前后经过腰腿痛VAS评分和ODI评分的结果显示,两组患者腰腿痛VAS评分和ODI评分均较术前明显降低,差异有统计学意义(P<0.05),术后3 d与术后3月随访比较显示,两组患者的腰痛VAS评分、腿痛VAS评分和ODI评分也显著降低,其差异均具有统计学意义(P<0.05)。A组与B组组间的腰痛VAS评分、腿痛VAS评分和ODI评分结果显示,两组组间差异不显著,均无统计学意义(P>0.05)。结论:PLDD能够明显降低腰椎间盘突出症患者的椎间盘内压力,改善患者临床症状,但临床疗效不受单点气化和双点气化的影响。In order to observe the clinical efficacy of single-point vaporization and double-point vaporization in the treatment of patients with lumbar disc herniation by percutaneous laser disc decompression(PLDD), 82 patients with lumbar intervertebral disc herniation were enrolled, and they were divided into two groups by random number table method, 41 cases in single-point gasification group in group A, 41 cases in double-point gasification group in group B, and both groups were local under anesthesia, a percutaneous stimulation phosgenation decompression operation was performed under the guidance of the "C" arm, and connected to a manometer to measure the pressure, compare the pressure difference in the intervertebral disc, and evaluate the clinical efficacy with MacNab, VAS, and ODI scores. The results show that all patients successfully completed PLDD under local anesthesia and completed the follow-up. The pressure in the lumbar intervertebral disc of the two groups of patients changed significantly before and after the operation, which was statistically significant(P<0.05), and the average average pressure difference before and after the operation was(5.2±1.6) mmHg, but the pressure in the lumbar intervertebral disc between group A and group B was not statistically significant(P>0.05);the preoperative and postoperative follow-up evaluation results of the two groups of patients showed that the excellent and good rate of patients in group A was 92.7%, the excellent and good rate of patients in group B was 90.2%, the total excellent and good rate was 91.5%, the total effective rate was 97.6%, and the total recurrence rate was 2.4%. There was no statistically significant difference in the excellent and good rate and effective rate between the two groups(P>0.05);The results of the low back pain VAS score and ODI score of the two groups of patients before and after treatment showed that the low back pain VAS score, leg pain VAS score and ODI score of the two groups were significantly lower than those before the operatio

关 键 词：腰椎间盘突出症 经皮穿刺激光气化减压术 椎间盘压力 临床疗效 

分 类 号：R312[医药卫生—基础医学] R683.2