【作者】 王炳良； 丁汇清； 黄小明； 王昭波； 孙伟； 喻国栋； 李兴侠；

【Author】 WANG Bingliang~* DING Huiqing~* HUANG Xiaoming et al.~*Department of Interventional Radiology,Haigang Hospital,Lianyungang,Jiangsu(222046);~*Department of Radiology the Second People,s Hospital of Lianyunguang City

【机构】 江苏连云港海港医院介入放射科； 江苏连云港市第二人民医院放射科；

【摘要】 目的:进一步探讨经皮椎间盘旋切治疗腰椎间盘突出症的疗效及其影响因素。方法共治疗1282例病人1912个椎间盘,其中有3例3个椎间盘未能成功进行切吸,实际手术1909 个椎间盘。文章回顾性地分析了①临床疗效与适应症和禁忌症;②疗效与椎间盘突出类型及程度的关系;③患者的临床症状与疗效;④患者的年龄及病程长短与疗效的关系;⑤髓核摘除量与疗效的关系。结果:手术成功率99.5;显效率79.7%(1022/1282);有效率15.3%(196/1282) 无效率4.8%(61/1282)。总有效率为95%。结论:①侧隐窝狭窄、病变椎间隙狭窄及突出的髓核钙化可作为相对适应症进行选择,"椎间盘手术史"不应作为绝对禁忌症;②包容型椎间盘突出治疗效果好;③疑有运动神经纤维不可逆性损伤者,不宜行 PLD;④对外伤后出现较重症状的年轻患者,施行 PLD 应慎重;⑤髓核摘除量越多,疗效越好,但部分只行破环减压者亦能获得较好疗效。更多还原

【Abstract】 Objective To eveluate the therapeutic effect and related factors of percutaneous lumbar diskectomy (PLD) on lumbar disc protrusion.Methods 1912 lumbar disc protrusion in 1282 cases treated by PLD in this series,among 3 disc in 3 cases were failure.The retropective analyses were taken as follows:① the correlation of the clinical effect to the indication and the contraindication,② the correlation of the therapeutic effect to the degree and types of the lumbar disc protrusion,③the corre- lation of the therapeutic effect to the clinical symptom,④ the correlation of the thera- peutic effect to the duration and the age of the patient,⑤ the correlation of the thera- peutic effect to the amount of disc tissue removed.Results The successful rate was 99. 5%,the curative and effective rates were 79.7% and 15.3% respectively.The overall effective rate was 95%.Conclusions ①The stenosis of the lateral recess and the in- tervertebral space & the disc with calcification might possibly be treated with PLD, "the history of operation on the lumbar disc" were not absolute contraindication.② The therapeutic effect of the contained lumbar disc protrusion was good.③ having irreversible motor nerve paralysis was contraindication.④The PLD to young patient who had injured and had severe symptom must be cautious.⑤The more amount of disc tissue removed,the more the therapeutic effect.But the better therapeutic effect were obtained on the part cases of the annulus fibrosus being trepanned and then the pres- sure of disc was decreased.更多还原