妊娠期合并腰椎间盘突出症的临床研究

Clinical Study on Herniated Lumbar Discs during Pregnancy

目的通过临床研究分析妊娠期合并腰椎间盘突出症(HLD)的病因,总结其诊断和治疗原则。方法回顾性总结了2005年9月至2008年2月间妊娠合并HLD的18例患者,对其发病机制及诊断、治疗特点加以分析。结果18例患者中有2例因HLD的诊断和治疗因素而中止妊娠;在脊柱科医师协作下,1例急诊行椎间盘减压术并中止妊娠,1例在行剖宫产同时行髓核摘除术;余14例均足月妊娠。结论妊娠期合并HLD与妊娠时的机体负荷增加、椎间盘退变、内分泌改变及体位变化有关。在物理和药物治疗无效的前提下可根据孕龄、胎儿成熟度、脊柱病变的严重程度和患者自身的态度等因素综合考虑手术指征。同时对妊娠期合并HLD病例的诊治需要多科室共同协作才能取得良好的临床结果。

Objective To emphasize the importance of the etiology, diagnosis and the therapeutic principle in dealing with the herniated lumbar discs during pregnancy. Methods We retrospectively reviewed and analysised 18 pregnant women who suffered from herniated lumbar discs during pregnancy between September 2005 to February 2008, and analysis the pathogenesis, diagnosis, and treatment characteristics. Results In 18 cases, 2 cases took termination of pregnancy before full-term; 1 case underwent partial hemilaminectomy and had a therapeutic termination of pregnancy; 1 patient underwent discectomy and a cesarean section at the same time, other 14 cases had a full-term fetation. Conclusion Pregnancy combined HLD patients body at the time of load increase, disc degeneration, endocrine changes and position changes. In the physical and drug therapy, under the premise is invalid according to gestational age, fetal maturity, the severity of the spinal lesion and the patient＇s own attitude considering factors such as surgical indications. At the same time of pregnancy diagnosis and treatment of pregnancy combined HLD patients, doctors need to work together to achieve good clinical results.