【摘要】 目的　研究影响自动式经皮穿刺腰椎间盘切除术 (APLD)治疗腰椎间盘突出症疗效的相关因素。方法　对 1 4 6例腰椎间盘突出症行APLD治疗并观察其疗效 ,分析影响术前、术中及术后疗效的因素。结果　疗效与适应症的选择有密切关系 ;与病程长短无明显统计学差异 (P >0 0 5) ;与椎间盘切除量呈抛物线改变 ;椎间盘的切除部位与发病年龄有一定的关系 ;术后适时、适度牵引治疗有助于APLD疗效的提高。结论　适应症选择是提高疗效关键因素之一 ;椎间盘的切除量以 2～ 3 5g为最佳 ;35岁以内椎间盘切除部位与疗效关系不明显 ,而大于 35岁切除部位偏中后为佳 ;术后 2～ 4周再行牵引治疗有助于疗效的提高更多还原

【Abstract】 Objective To study the related factors affecting the therapeutic effect of Auto Percutaneous Lumbar Diskectomy(APLD) Methods 146 cases of lumbar disc herniation were treated with APLD and observations were made on the related factors affecting the therapeutic effect.Results The therapeutic effect were in close association with the selection of the right indication;the course of the illness did not affect the final results (P>0 05).The long or shore of the relation between therapeutic effect and the amount of removed disc material demonstrated a parabola curve.The sites of disc removal bore some relationship with the age of patients.Proper timely traction was able to improve the therapeutic result of APLD.Conclusion The choice of indication is one of the critical factors.The properly excised amount of disc material should be 2 to 3 5 grams.The site of excision in patients under 35 years of age bears no significant difference to the therapeutic effect;however,in those over 35,it is better to remove the central and the posterior part.Traction for 2～4 weeks after operations helps to improve the therapeutic effect.更多还原