腰椎间盘膨隆与间盘疝的相关性分析

Analyzing the Relationship Between Lumbar Intervertebral Disc Bulging and Intervertebral Disc Herniation

为探讨腰椎间盘膨隆（ＢｕｌｇｉｎｇＢ）与间盘疝（ＨｅｒｎｉａｔｉｏｎＨ）的相关性，对４６８例腰腿痛患者共９６９个椎间盘ＣＴ扫描结果进行了统计分析。分组：１８～３０岁（Ⅰ组），３１～４０岁（Ⅱ组），４１～５０岁（Ⅲ组），５１～８０岁（Ⅳ组）。共检出有退行性病变者８３５个（８６．１７％）；检出率４组之间差异无统计学意义（χ２＝３．０６５，Ｐ＞０．０５），其中Ｂ５４１个，Ｈ９３个，间盘膨隆伴疝（ＢＨ）２０１个，检出率分别为５５．８３％（５４１／９６９）、９．６％（９３／９６９）和２０．７４％（２０１／９６９）。Ｂ者Ⅲ组低于Ⅰ组（χ２＝４．２５，Ｐ＜０．０５）而ＢＨⅢ组高于Ⅰ组（χ２＝４．５５２，Ｐ＜０．０５）和Ⅱ组，表明随着年龄增加有一部分Ｂ者又发生了ＢＨ或Ｈ，致使Ｈ和／或ＢＨ的发生率增高；另外，Ｌ４、５退行性病变的检出率高于Ｌ５、Ｓ１和Ｌ３、４，同时ＢＨ检出率也是Ｌ４、５高于Ｌ５、Ｓ１和Ｌ３、４；Ｈ的检出率Ｌ５、Ｓ１高于Ｌ４、５和Ｌ３、４。本研究显示：青年腰痛患者腰间盘已有明显退变，Ｂ与ＢＨ和Ｈ有着多方面联系和某些相关性，重视Ｂ特别是青年腰间盘膨隆症的诊治，对减少ＢＨ和Ｈ的发病率及腰椎其它结构的继发性退变有重要?

To study the relationship between lumbar intervertebral disc bulging (B) and intervertebral disc herniation (H),468 patients with lumbodynia was classified by four groups (Ⅰ8-30Y Ⅱ31-40Y Ⅲ41-50Y Ⅳ51-80Y)and 969 intervertebral disc CTscanning was taken.As results,the rate of the degeneration of lumbar vertebrae was 86.17% (835/969),and there was no difference between the four groups(χ 2=3.065,P>0.05).The percentage of B、H and intervertebral disc bulging and herniation (BH) was 55.83%(541/969)、9.6%(93/969)、20.74%(201/969),respectively.The rate of the degeneration of lumbar vertebrae was significantly difference between Ⅰand Ⅲ in both B and BH (B:χ 2=4.552,BH:χ 2=4.25,P<0.05),and in L 4,5 was higher than in L 5、S 1and L 3,4 .It ws indicated that B、BH and H were related.The degeneration of lumbar vertebrae was increased with ages.Emphasizing the diagnosis and treatment of B was very importment in decreasing the incidence of BH and H as well as the secondary degeneration of lumbar vertebra especially in the youth.