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经皮激光汽化术治疗腰椎间盘突出症的疗效观察
引用本文:张学学,王侃,翁泽林,喻燕波,王志剑,张达颖.经皮激光汽化术治疗腰椎间盘突出症的疗效观察[J].实用临床医学(江西),2008,9(1):45-47.
作者姓名:张学学  王侃  翁泽林  喻燕波  王志剑  张达颖
作者单位:[1]南昌大学第一附属医院疼痛科,南昌330006 [2]南昌大学医药科技开发中心,南昌330006
摘    要:目的探讨应用经皮穿刺激光汽化减压术(PLDD)治疗腰椎间盘突出症的疗效、并发症及不良反应。方法将32例腰椎间盘突出症患者(共36个病变椎间盘),在C型臂X线机引导下用18号穿刺针穿刺(经安全三角区或者小关节内缘入路)定位至病变椎间盘髓核部位后,插入660μm激光光纤,给予功率调整在10~16W,脉冲持续与间隔各为1.0s,总能量控制在1200~2800J,行激光汽化术。术后常规给予抗生素、卧床及对症治疗。结果术后随访3月,按照改良Macnab方法进行评定,优28例,良4例,差0例,有效率为100%。治疗过程全部患者无严重疼痛及症状加重,无脊髓、硬脊囊、血管、神经等重要脏器损伤。结论该方法在适应证选择严谨、影像引导下操作的情况下,定位准确、穿刺顺利、成功率高、疗效佳,无不良反应及严重并发症,是一种安全有效的治疗方法。

关 键 词:PLDD  腰椎间盘突出症  激光治疗  微创手术
文章编号:1009-8194(2008)01-0045-03
修稿时间:2007年9月21日

The Treatment of Lumbar Disc Herniation with Percutateous Laser Disc Decompression
ZHANG Xue-xue,WANG Kan,WENG Ze-lin,YU Yan-bo,WANG Zhi-jian,ZHANG Da-ying.The Treatment of Lumbar Disc Herniation with Percutateous Laser Disc Decompression[J].Practical Clinical Medicine,2008,9(1):45-47.
Authors:ZHANG Xue-xue  WANG Kan  WENG Ze-lin  YU Yan-bo  WANG Zhi-jian  ZHANG Da-ying
Institution:ZHANG Xue-xue, WANG Kan, WENG Ze-lin, YU Yan-bo, WANG Zhi-jian, ZHANG Da-ying (1. Department of Pain ,the First Affiliated Hospital ;2. Development Center of Medicina and Science and Technology, Nanchang University, Nanchang 330006,China)
Abstract:Objective To review the clinical results of percutaneous laser disc decompressin (PLDD) in the treatment of lumbar disc herniation. Methods PLDD was adopted in the treatment of lumbar disc herniation in 32 patients with 36 discs. The laser fiber was introduced into the herniated disc space with the needle puncturing percutaneously in surface of low back, at the site of 8-12 cm length to the midline under fluoroscopic guidance. The ND:YAG laser was of 810 wave-length, and the diameter of the fiber was 600 μm. The laser output power was 10-16 W with ls emission and ls interval. The compression of spinal cord and surrounding tissues were eliminated by reducing the intra-disc pressure through the vaporization of the disc nucleus. The total laser output power was decided depending on the age of the patients, degenerative degree of the disc, herniative levels and the reactive process of heat. Generally, the total powers were 1 200-2 800 J. Results The patients were followed-up regularly. The mean follow-up was 3 months and the longest was 12 months. The clinical evaluation was classified as excellent in 28 cases and good in 4 cases. There was no complications occurred. Conclusion PLDD could effectively relieve the symptoms and signs of patients with lumbar disc herniation. PLDD is easy to manipulated, safe, effective, mini-invasive.
Keywords:percutaneous laser disc decompressin  lumbar disc herniation  laser surgery  minimally Invasive surgery
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