本文選題：PLDD　切入點：治療　出處：《青島大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:通過對經皮穿刺激光減壓術(PLDD)治療腰椎間盤突出癥患者的近期、中、遠期臨床癥狀、腰椎的影像學改變進行隨訪評估,分析PLDD治療腰椎間盤突出癥對腰椎穩(wěn)定性的影響,評估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)院行經皮穿刺激光減壓治療腰椎間盤突出癥的82例患者,共135個椎間盤,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)經皮穿刺激光減壓術治療。術后3、6、12、24個月進行隨訪,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,計算椎間高度指數,評估其椎間盤容積變化。研究PLDD治療腰椎間盤突出癥對腰椎穩(wěn)定性的影響,分析其結果。結果:本組82例腰椎間盤突出癥患者,共135個腰椎間盤突出(L4-L5組13例;L5-S1組16例;混合組53例)穿刺成功率100%。術后3、6、12、24個月進行隨訪,各組術后X線下椎間隙高度、術后椎體高度、椎體矢狀位長度、椎間高度指數、椎間孔高度均示各個階段無明顯差異(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(不同隨訪時間段):與手術前比較術后即刻、術后3月、術后6月、術后12月、術后24月無明顯差異(p㧐0.05)。且與術前相比各個時間段位移均小于3mm。各組術后臨床療效:術后優(yōu)良率較高,術后各個時間階段療效無明顯差異(p㧐0.05)。結論:經皮激光減壓術治療腰椎間盤突出癥近期、遠期效果明顯,且不影響脊柱穩(wěn)定性,有利于患者早期恢復。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.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.3

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相關期刊論文 前10條

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本文編號：1643955