加压冲洗在腰椎间盘髓核摘除术中的作用(附120例前瞻性研究)

The Advantage of Pressed Irrigation Approach for the Treatment of Lumbar Disc Herniation:a Prospective Study of 120 Cases

目的：探讨加压冲洗在腰椎间盘髓核摘除术中的作用方法：对120例单节段腰椎间盘突出症手术患者随机分为两组，每组60例，分别采取不同方式处理腰椎间隙。其中实验组平均年龄35．6岁（26岁～62岁）术中用硬膜外穿刺针反复椎体间加压冲洗并钳取，以取尽髓核组织。对照组平均年龄46．5岁（23岁～78岁）术中未行加压冲洗。结果：实验组平均随访13．5个月，对照组平均随访15个月，对照组原位复发3例，同间隙对侧复发1例，均做二次手术而缓解。采用改良MacNab标准评定随访结果，实验组77％患者达优，20％患者达良，3％患者可，对照组68％患者达优，21％患者达良，4．3％患者可，差患者6．7％，近期症状改善情况与实验组相似。结论：同实验组比较，对照组表现相似的短期临床效果，加压冲洗的方法使取尽髓核有了一个量化的标准，加大手术效果的优点。

Objective： To investigate the advantage of pressed irrigation in the treatment of lumbar disc herniation. Methods： We divided the 120 cases into two groups at random, each 60 cases.Diffferent approaches were used to treat lumbar disc clearance. During the operation, we nipped and took out the disc tissue by using the extradural puncture needle to have the pressed irrigation in the experimental group （average age 35.6 years, range from 26 to 62 years）. Controll group of 60 cases（average age 46.5 years, range from 23 to 78years） treated without the pressed irrigation. We made a prospective study. Results： The irrigation group received 13.5 months＇follow-up and no recurred and the functional evaluation results were classified with modified ＂MacNab＂ , excellent 77%, good 20%, fair 3%. And the non- irrigation group received 15 months＇follow-up. Four cases recurred and released after a second operation and excellent 68%, good 21%, fair 4.7% and not so good 6.7%. Conclusion： Compared to the experimental group, the non-pressed group has a similar short-term clinical effect. The method gives the operation a measuring standard and enhances a good effect.