CT引导下经皮激光切割椎间盘术加臭氧氧化髓核术联合治疗颈腰椎间盘突出症.doc

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1、CT引导下经皮激光切割椎间盘术加臭氧氧化髓核术联合治疗颈•腰椎间盘突出症CT引导下经皮激光切割椎间盘术加臭氧氧化髓核术联合治疗颈.腰椎间盘突出症发表时间：2008-12-28发表者：王明明（访问人次：283）王明明周四学李辉王勇唐元德占祥友刘灵军张鑫晟【摘要】目的探讨经皮激光椎间盘气化术（PLDD）加臭氧（03）髓核氧化术联合治疗腰椎间盘突出症的疗效方法应用医用半导体激光（功率3T5W,波长980nm）,医用臭氧发生器，在CT引导下采用18G穿刺针经皮穿刺至髓核区，然后由穿刺针插入600um光导纤维，用自动脉冲式激光切割、汽化髓核，以每个椎间盘600-800J切割、汽化，再向椎间盘

2、內注入浓度为60ug/mlO3约共治疗216例319节椎间盘。疗效判定标准采用Macnab的标准［1］。结果随访个月后，216例患者术中，有147例疗效为优，59例为良，6例为有效，4例为差；优良率：95.4%,有效率2.8%,差1.8%。，无任何严重的并发症发生。结论经皮激光椎间盘汽化术加臭氧髓核氧化术组合治疗治疗腰椎间盘突出症，具有创伤小，痛苦少，安全性高，疗效佳的特点，值得在临床上推广。关健词激光椎间盘汽化术臭氧髓核氧化术腰椎间盘突出症联合治疗PercutaneousLaserDiskDecompressionCombiningOzoneNucleusGelatinosusO

3、xidizingTechniqueTreatsLubarIntervertebralDiscProtrusion[Abstract]ObjectiveToexplorethetherapeuticeffectsofPercutaneousLaserDiskDecompression(PLDD)combiningOzoneNucleusGelatinosusOxidizingTechniquetotreatLubarIntervertebralDiscProtrusion(LIDP).MethodsUnderCTguidanee,thespinalneedlewasinsertedi

4、nthespaceofthenucleusgelatinosus.216patientswith319intervertebraIdisksweretreatedbyautopulsed・wavemodelasercuttingandvaporizing(withthepowerof600-800Jforeachintervertebraldisk)andthen03(8-12mlwithconcentrationof60ug/ml)wasinfluxed.TherapeuticeffectswerejudgedbyMacnab'standard.ResultsAmongtheto

5、tal216patientswiththefollowupof3to30months,147patientshadexcellenttherapeuticeffects,59patientshadgoodtherapeuticeffects,6patientshadsometherapeuticeffectsand4patientshadnotherapeuticeffects.Thetotalexcellentandgoodeffectiverateis94.5%,2.8%withsometherapeuticeffectsand1.8%withnotherapeuticeffe

6、cts.Nocomplicationswereoccurredamongthepatients.ConelusionThemethodthatPercutaneousLaserDiskDecompress!on(PLDD)combiningOzoneNucleusGelatinosusOxidizingTechniquetreatsLubarIntervertebralDiscProtrusion,withadvantagesoflittleinjuryandpain,highsafetyandbettertherapeuticeffect,canbewidelyappliedin

7、clinic.【Keywords]PercutaneousLaserDiskDecompression(PLDD);Ozone;NucleusGelatinosusOxidizingTechnique;LubarIntervertebraIDiscProtrusion(LIDP);Therapeuticalliance腰椎间盘突出症为临床常见病，多发病，临床表现为腰痛伴或不伴下肢疼痛，严重者可表现为卧床不起，行走困难，二便障碍。该病多发生在25・40岁Z间。给人们的身