医药学论文：腰椎间盘突出症伴脊椎侧突的PLD术入路探讨

【摘要】 目的 针对不同的腰椎间盘突出症伴脊柱侧突的患者，寻求最佳的PLD术入路途径，以提高手术的治疗效果。方法 在192例腰椎间盘突出症伴有脊柱侧突的患者，根据CT等影像学的表现，分为脊神经根内压迫型（A型）68例、脊神经根外压迫型（B型）45例及混合型（C型）79例，每型又随机分为观察组和对照组。其中，观察组采用健侧入路，对照组采用患侧入路的方式施行PLD术，最后进行术后疗效的观察、对比和分析。结果 依Nakai疗效判定标准，A型的观察组优良率82.35%，对照组优良率67.65%,经统计学处理，P< 0.05，差异有显著性。而B型和C型的观察组优良率均为80.00%，对照组优良率各为80%、81.82%,经统计学处理，P>0.05，差异无显著性。结论 在腰椎间盘突出症伴脊柱侧突患者施行PLD术时，脊神经根内压迫型（A型）宜采用健侧入路；而脊神经根外压迫型（B型）及混合型（C型）则不受入路途径的影响，但在部分严重侧突的病人，首选以患侧入路为佳。

 

【关键词】 腰椎间盘突出症；脊柱侧突；经皮髓核切吸术；入路途径

 

The investigate of fld operation' way in lunbar interverbral disc protrusion with the spinal columu side outstanding disease

 

【Abstract】 Objective Aim at to be different suffer from lumber disc herniation to have accompanied with the spinal column side outstanding disease patient，look for the best PLD surgical operation to go into journey path to raise the treatment result of surgical operation.Methods At 192 suffer from lumber disc herniation to have accompanied with the spinal column side outstanding disease on the sick list person，copying the performance that the elephnt learns according to CT'etc.ising divided into ridge never an oppression type（A type）68，ride never root outside oppression a type（B type）45 and mixture type（C type）are 79 inside root，each again is divided into observation set and matched control random.Among them，the observation set adopts a health side to go int o road，the matched control adoption suffers from the PLD surgical operation of the way enforcement that the side goes，into road，carrying on observation，contrat and analysis of curative effect finally after operation.Results Judge according to Nakai curative effect sdandard，the observation set of A type good rate is 82.35%，the matched control good rate is 67.65%，wasing learned by covariance processing，P< 0.05，there is obvious difference.But the observation set B type and C type the good rate is all 80.00%，matched control good rate are 80%、 81.82% perspectively，was learned by covariance processing，P>0.05，have no obvious difference.Conclusion In to contracts lumber disc herniation to have accompanied with the spinal column side outstanding disease patient to implement PLD surgical operation，the ridge never an oppression type（A type） inside the root is proper to adopt a hralthy side to go into road；But ridge never root influence which then is free from into the journey path of the outside oppression tpye（B type） and mixture type（C type），but at part of serious side outstanding patient，the first chooses to take suffering from a side to go into road as good.