本文選題：PLDD　切入點(diǎn)：治療　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過對(duì)經(jīng)皮穿刺激光減壓術(shù)(PLDD)治療腰椎間盤突出癥患者的近期、中、遠(yuǎn)期臨床癥狀、腰椎的影像學(xué)改變進(jìn)行隨訪評(píng)估,分析PLDD治療腰椎間盤突出癥對(duì)腰椎穩(wěn)定性的影響,評(píng)估PLDD治療腰椎間盤突出癥的臨床治療效果。方法:選取2013年2月--2014年11月在山東昌邑市人民醫(yī)院行經(jīng)皮穿刺激光減壓治療腰椎間盤突出癥的82例患者,共135個(gè)椎間盤,按發(fā)病部位不同分為L4-L5組13例;L5-S1組16例;混合組53例。采用波長為1064nm的ND-YAG脈沖式激光行常規(guī)經(jīng)皮穿刺激光減壓術(shù)治療。術(shù)后3、6、12、24個(gè)月進(jìn)行隨訪,觀察其臨床癥狀、X線下椎間隙高度、椎體高度、椎間孔高度,測量其過伸過曲位相鄰椎體位移,計(jì)算椎間高度指數(shù),評(píng)估其椎間盤容積變化。研究PLDD治療腰椎間盤突出癥對(duì)腰椎穩(wěn)定性的影響,分析其結(jié)果。結(jié)果:本組82例腰椎間盤突出癥患者,共135個(gè)腰椎間盤突出(L4-L5組13例;L5-S1組16例;混合組53例)穿刺成功率100%。術(shù)后3、6、12、24個(gè)月進(jìn)行隨訪,各組術(shù)后X線下椎間隙高度、術(shù)后椎體高度、椎體矢狀位長度、椎間高度指數(shù)、椎間孔高度均示各個(gè)階段無明顯差異(p㧐0.05)。椎間盤容積:L4-L5組、L5-S1組、混合組均有顯著差異(p0.05)。各組相鄰椎體間位移(不同隨訪時(shí)間段):與手術(shù)前比較術(shù)后即刻、術(shù)后3月、術(shù)后6月、術(shù)后12月、術(shù)后24月無明顯差異(p㧐0.05)。且與術(shù)前相比各個(gè)時(shí)間段位移均小于3mm。各組術(shù)后臨床療效:術(shù)后優(yōu)良率較高,術(shù)后各個(gè)時(shí)間階段療效無明顯差異(p㧐0.05)。結(jié)論:經(jīng)皮激光減壓術(shù)治療腰椎間盤突出癥近期、遠(yuǎn)期效果明顯,且不影響脊柱穩(wěn)定性,有利于患者早期恢復(fù)。是一種有效的微創(chuàng)治療方法。
[Abstract]:Objective: to evaluate the recent, middle and long term clinical symptoms and imaging changes of lumbar disc herniation treated by percutaneous laser decompression, and to analyze the effect of PLDD on lumbar disc herniation. Methods: from February 2013 to November 2014, 82 patients with lumbar disc herniation were treated by percutaneous puncture laser decompression in Changyi people's Hospital, Shandong Province. The patients were divided into L4-L5 group (n = 13), L5-S1 group (n = 16) and mixed group (n = 53). Conventional percutaneous laser decompression was performed with ND-YAG pulse laser at 1064nm. The height of intervertebral space, the height of vertebral body and the height of intervertebral foramen were observed. The displacement of adjacent vertebrae was measured and the index of intervertebral height was calculated. To evaluate the changes of intervertebral disc volume, to study the effect of PLDD on lumbar disc herniation and to analyze the results. Results: in this group of 82 patients with lumbar disc herniation, there were 13 patients with L4-L5 lumbar disc herniation and 16 patients with L5-S1 group. The success rate of puncture was 100% in the mixed group (n = 100). All the patients were followed up for 24 months. The height of the intervertebral space, the height of the vertebral body, the length of the sagittal position, the index of the intervertebral height and the height of the intervertebral foramen showed no significant difference in each stage. The volume of intervertebral disc in group 1: L4-L5 was significantly different from that in group L5-S1, and there was no significant difference in the displacement of adjacent vertebrae between the two groups (different follow-up periods: immediately after operation, March, June, December, 24 months after operation). The displacement of each time period was less than 3mmm. the clinical effect of each group was higher than that of preoperation, and there was no significant difference in the curative effect at each time stage after operation. Conclusion: percutaneous laser decompression is an effective and minimally invasive method for the treatment of lumbar disc herniation.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.3

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相關(guān)期刊論文 前10條

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本文編號(hào)：1643955