腰椎间盘突出症的临床诊断价值

The Value of Clinical Diagnosis in Lumber Disc Herniation

目的 :探讨临床诊断在腰椎间盘突出症诊断中的价值。方法 :回顾 1 4 84例腰椎间盘突出症住院病历 ,将临床诊断与 CT诊断比较。结果 :出现频率最高的症状是腰痛和腿放射痛 ,加上出现频率最高的体征椎间隙压痛及直腿抬高试验阳性 ,此四项指标与 CT检查对比能反映同一问题 ( P<0 .0 5) ,确诊与误诊患者间的四项指标及 CT检查均有显著差异 ( P<0 .0 1 ) ,椎间隙压痛与 CT的椎间隙定位吻合率高于 X线与 CT的吻合率 ( P<0 .0 1 ) ,中央型与旁侧型的体征差异主要是直腿抬高试验 ( P<0 .0 1 )。结论 :临床诊断是腰椎间盘突出症诊断及鉴别诊断中最重要的诊断方法 ,上述四项指标是诊断该病的主要临床诊断指标。

Objective:To study the value of clinical diagnosis in lumber disc herniation(LDH).Methods:Retrospective study was conducted on the clinical diagnosis and the CT imaging diagnosis in 1484 patients with LDH.Results:The frequency of symptom were higher in lumbodynia and sciatica, and the frequency of sign were interspinal tenderness and Lasegue sign. The relative of the four targets and the CT imaging diagnosis can reflect same problem (P<0.05 ).The differece between diagnostic cases and erroneous diagnosis is highly significant (P<0.01). The rates of intervertebral location in interspinal tenderness and CT is higher than in X ray and CT (P<0.01 ).There are difference between centric type and side type in Lasegue sign (P<0.01 ).Conclusion:Clinical diagnosis is the most important in diagonosis and diffrential diagnosis for LDH.As mentioned above,the four targets are the main target in diagnosis of LDH.