硬膜外腔液压冲击法治疗腰椎间盘突出症

Epidural Liquid Lash for Treatment of Lumbar Disc Herniation

目的评估硬膜外腔液压冲击法治疗腰椎间盘突出症的临床效果。方法５３例病人，经Ｌ３－４／Ｌ４－５间隙正中法行硬膜外腔穿刺，在局麻注射激素后快速注入４０～６０毫升ＮＳ，每周注射一次，４周为一疗程，最多行二个疗程。结果治疗后症状体征全部消失１３例（２４．５％）；症状体征显著减轻２１例（４０％）；治疗后症状体征有缓解，但不显著１１例（２０．５％）；治疗后症状无明显减轻８例占１５％。结论硬膜外腔液压冲击疗法对腰椎间盘突出症是安全有效的治疗方法。但对腰椎侧弯明显、侧隐窝变窄和髓核脱出者效果不满意。

Objective To assess the clinical effect of epidural liquid lash for treatment of lumbar disc her niation. Method Fifty three patients were observed. All patients received an epidural puncture at L 3 4 or L 4 5 interspace via midline approach. After local anesthetics and steroid injection, 40￣60 ml normal saline was quickly injected epidurally, once a week for 4 weeks, maximally for two courses. Results The symptoms and signs disappeared completely in 13 patients (24.5%), the symptoms and signs relieved markedly in 21 patients (40%), the symptoms and signs relieved, but not markedly in 11 patients (20.5%), no evident improvement was found in 8 patients (15%). Conclusions Epidural liquid lash is a safe and effective therapeutical method for patients with lumbar disc herniation. But its efficiency wasn't satisfactory in patients with marked scoliosis of lumbar vertebae, stenosis of lateral recess and, hernition of nucleus pulposus.