基于量化评分表的腰椎间盘突出症阶梯化治疗策略  

Stepwise treatment strategy for lumbar disc herniation based on quantitative scoring table

作　　者：张军[1] 王芸[1] 朱华丽 刘婷婷[1] 邓玉霞 陈华伦 ZHANG Jun;WANG Yun;ZHU Huali;LIU Tingting;DENG Yuxia;CHEN Hualun(Pain Department,Shapingba Hospital,Chongqing University/People's Hospital of Shapingba District,Chongqing 400030;Pain Department,Yubei Hospital,the First Affiliated Hospital ofChongqing Medical University,Chongqing 401120,China)

机构地区：[1]重庆大学附属沙坪坝医院/重庆市沙坪坝区人民医院疼痛科,重庆400030 [2]重庆医科大学附属第一医院渝北医院疼痛科,重庆401120

出　　处：《临床医学研究与实践》2025年第7期66-69,122,共5页Clinical Research and Practice

基　　金：重庆市沙坪坝区决策咨询与管理创新项目(No.Jcd202245);2022年重庆市沙坪坝区科卫联合医学科研项目(No.2022SQKWLH016)。

摘　　要：目的制定腰椎间盘突出症阶梯化治疗量化评分表,初步评估基于量化评分表的腰椎间盘突出症阶梯化治疗策略的可行性。方法回顾性选取2022年7月至2023年4月就诊于重庆市沙坪坝区人民医院疼痛科的50例腰椎间盘突出症患者为研究对象,根据症状、体征、影像表现、神经肌电图等资料,采用我科专用椎间盘突出阶梯化治疗量化评分表进行评估,评分<20分推荐保守治疗、20~40分推荐介入治疗、>40分推荐微创手术治疗。比较保守治疗组、介入治疗组、微创手术组的椎间盘突出阶梯化治疗量化评分表评分,以及不同时间点的腰痛、臀部及下肢痛评分。结果介入治疗组与保守治疗组的椎间盘突出阶梯化治疗量化评分表评分比较,差异具有统计学意义(P=0.006);微创手术组与介入治疗组的椎间盘突出阶梯化治疗量化评分表评分比较,差异具有统计学意义(P<0.001)。治疗后,三组的腰痛评分均低于入院时(P<0.05);治疗后,微创手术组的臀部及下肢痛评分低于入院时(P<0.05)。结论腰椎间盘突出阶梯化治疗量化评分表能较为准确地反映患者的治疗需求,是一种能够为临床诊疗提供参考的工具。Objective To formulate the quantitative scoring table for the stepwise treatment of lumbar disc herniation,and preliminarily evaluate the feasibility of the stepwise treatment strategy for lumbar disc herniation based on the quantitative scoring table.Methods A total of 50 patients with lumbar disc herniation who were admitted in the pain department of People's Hospital of Shapingba District of Chongqing from July 2022 to April 2023 were retrospectively selected as the research objects.According to the symptoms,signs,imaging findings,neuromyography and other data,the quantitative scoring table for the stepwise treatment of lumbar disc herniation in our department was used to evaluate the patients.Conservative treatment was recommended when the score is less than 20 points,interventional treatment was recommended when the score is between 20 and 40 points,and minimally invasive surgical treatment was recommended when the score is greater than 40 points.The score of quantitative scoring table for the stepwise treatment of lumbar disc herniation,and the scores of low back pain,hip and lower limb pain at different time points in the conservative treatment group,the interventional treatment group and the minimally invasive surgical group were compared.Results There was a statistically significant difference in the score of quantitative scoring table for the stepwise treatment of lumbar disc herniation between the interventional treatment group and the conservative treatment group(P=0.006);there was a statistically significant difference in the score of quantitative scoring table for the stepwise treatment of lumbar disc herniation between the minimally invasive surgical group and the interventional treatment group(P<0.001).After treatment,the low back pain score of the three groups was lower than that at admission(P<0.05);after treatment,the hip and lower limb pain score of the minimally invasive surgical group was lower than that at admission(P<0.05).Conclusion The quantitative scoring table for the stepwise treatmen

关 键 词：腰椎间盘突出症 阶梯化治疗 保守治疗 介入治疗 微创手术治疗 

分 类 号：R681.53[医药卫生—骨科学]