经皮激光椎间盘汽化减压术结合硬膜外填充术临床研究

Clinical research of percutaneous laser disc decompression combined with epidural filled technique

目的观察并比较单纯行硬膜外填充术或单纯行经皮椎间盘汽化减压术（PLDD）与两法结合的治疗效果。方法选取腰椎间盘突出症患者384例，随机分为3组：单纯行硬膜外填充术治疗组90例，单纯行PLDD术治疗组89例，PLDD术结合硬膜外填充术治疗组205例。于治疗前和治疗后3、12个月采用VAS评估疼痛程度，并观察治疗前后临床体征变化。结果单纯行PLDD术治疗组显效、有效、好转、无效依次为89．8％（79／89例）、4．5％（4／89例）、4．5％（4／89例）、2．2％（2／89例）；单纯行硬膜外填充术治疗组显效、有效、好转、无效依次为75．6％（68／90例）、11．1％（10／90例）、o．0％（0／90例）、13．3％（12／90例）；PLDD术结合硬膜外填充术治疗组显效、有效、好转、无效依次为96．6％（198／205例）、3．4％（7／205例）、0．0％（0／205例）、0．0％（0／205例）。结论PLDD术结合硬膜外填充术治疗腰椎间盘突出症疗效优于单纯行硬膜外填充术或单纯行PLDD术。

Objective To observe and compare the therapeutic effects of epidural filled technique, PLDD and combination of these two methods. Methods 384 patients with lumbar disc herniation were selected and randomly divided into three treatment groups： epidural filled group 90 cases, PLDD group 89 cases, PLDD combined with epidural filled group 205 cases. VAS was used to assess pain intensity and to observe the change of clinical signs before and 3, 12 months after the treatment. Results The rates of good, effectiveness, improvement and failure in PLDD group were 89.8% （79/89 cases）, 4.5 % （4/89 cases）, 4.5% （4/89 cases）, 2.2 % （2/89 cases） respectively, in epidural filled technique group were 75.6%（68/90 cases）, 11. 1% （10/90 cases） , 0.0%（0 / 90 cases）, 13.3% （12/90 cases） respectively and in PLDD combined with epidural filled technique were 96.6% （198/205 cases）, 3.4%（7/205 cases）, 0.0%（0/205 cases）, 0.0%（0/205 cases） respectively. Conclusion The therapeutic effects of the combination of epidural filled and PLDD is superior than sepa- rated these technique on lumbar disc herniation.