经皮激光汽化技术特点与腰椎间盘突出症治疗相关因素的研究及应用

Percutaneous laser vaporization for treating lumbar intervertebral protrusion

目的:总结经皮激光汽化技术特点并分析其在腰椎间盘突出症治疗的应用及临床疗效的关系。资料来源:应用计算机检索万方数据库1998-01/2006-12与激光治疗腰椎间盘突出相关的文章,检索词为“激光,腰椎间盘突出”,并限定文章语言种类为中文。资料选择:对资料进行初审,纳入标准:文章所述内容涉及激光在腰椎间盘突出症的应用情况、疗效研究、作用机制以及研究现状等内容;排除标准:重复研究以及Meta分析类文章。资料提炼:共收集64篇有关文献,进一步查找全文,纳入30篇符合标准的文献,其中7篇论述经皮激光汽化治疗腰椎间盘突出症的机制,3篇讨论激光的种类和优缺点,20篇关于经皮激光椎间盘减压术的适应证、禁忌证、操作方法、疗效及术后处理。资料综合:Nd:YAG激光、Ho:YAG激光、CO2激光、KTP激光和半导体激光都能用于经皮激光椎间盘减压术,临床应用比较广泛的是Ho:YAG激光和半导体激光。经皮激光椎间盘减压术同传统手术相比,具有以下优点:①操作简单,手术时间短,可同时进行多个椎间盘病变的治疗。②不影响脊柱的稳定性。③术后疼痛少,恢复快。只要严格掌握手术适应证,手术操作正确,大部分患者能达到满意的效果。结论:经皮激光汽化是治疗腰椎间盘突出症的有效方法,如果能够做到诊断准确,病例选择适宜,可以获得优良的疗效。

OBJECTIVE： To summarize the characteristics of percutaneous laser vaporization technique, and analyze the clinical treatment outcome of healing the lumbar intervertebral protrusion. DATA SOURCES： The literatures about the laser therapy for lumbar intervertebral protrusion were collected from Wanfang database published from January 1998 to December 2006 with the key words of ＂laser, lumbar intervertebral protrusion＂ in Chinese. STUDY SELECTION： The literatures were selected primarily and literatures were collected. Inclusive criteria： ①involved in the implemented circumstance, therapeutic study, action mechanism and investigative situation. Exclusive criteria： repeated study and Meta analytical papers. DATA EXTRACTION： Totally 64 papers of healing the lumbar intervertebral protrusion with laser were selected and looked up for full-texts. And 30 of them accorded with the inclusive criteria, 7 discussed the mechanism of percutaneous laser vaporization for healing the lumbar intervertebral protrusion, 3 probed into the type, advantage and disadvantage of laser, 20 referred to the indication, contraindication, operational method, curative effect and post processing of percutaneous laser disk decompression. DATA SYNTHESIS： Percutaneous laser disk decompression, such as Nd：YAG laser, Ho：YAG laser, CO2 laser, KTP laser and semiconductor laser, is an effective way to cure the lumbar intervertebral protrusion, which is superior to the traditional operation in such aspects as： ①simple and short procedure, simultaneous therapy for various intervertebral dick disorder. ②no impact on spinal stability. ③few pain and rapid rehabilitative post-operation. It can be mastered with strictly operative indication and with accurately operative procedure. A majority of patients can achieve satisfying effect, and Ho：YAG laser and semiconductor laser are the most widely applied. CONCLUSION： The lumbar intervertebral protrusion can be well healed with percutaneous laser vaporization, with accurate diagnosis and suitable selection for patients.