腰椎间盘突出症非手术治疗适应证的合理选择

Proper Selection of the Indications of Non-operative Treatment of Lumbar Disc Herniation

目的探讨腰椎间盘突出症非手术治疗的适应证的临床合理选择。方法回顾性分析2010-01/2014-06犍为县中医医院骨科收治的131例腰椎间盘突出症患者,其中采用非手术治疗125例,男性78例,女性47例。年龄25~62岁,平均36.5岁;病程7 d^3.5个月;均有不同程度的腰腿痛,CT与MRI显示椎间盘膨出型81例、突出型44例;均经卧床休息、腰椎牵引、手法推拿、针灸和药物等综合治疗。结果获得随访125例,随访时间最长4年,最短6月。按疗效评定标准评定:治愈70例,显效29例,有效18例,无效8例。总有效率约93.6%。末次随访无复发病例。结论治疗腰椎间盘突出症,应根据椎间盘突出程度和形态分型,合理选择个体化治疗方案,只要适应证选择恰当,非手术治疗效果良好。

Objective To exlpore the clinical proper choice of non- surgical treatment of lumbar disc herniation of indications. Methods A retrospective analysis was conducted in 131 treated patients with lumbar disc herniation during January 2010 to June 2014. The total number of non- surgical treatment was 125 cases,including78 male cases and 47 female cases. The patients were aged 25 to 62 years,mean 36. 5 years,with the duration of 7 days to 3. 5 months. They had varying degree of low back pain. With CT and MRI 81 cases showed a bulging disc type,44 cases showed protrusion type. All cases were confirmed by bed rest,lumbar traction,massage techniques,acupuncture and medication comprehensive treatment. Results A total number of 125 cases were followed up for up to four years,with the minimum of six months. They were assessed according to evaluation criteria: cured 70 cases,significant effect in 29 cases,effective in 18 cases and ineffective in 8 cases. The total efficiency rate was 93. 6%. No recurrence was found in the last follow- up. Conclusion The treatment of lumbar disc herniation should be chosen properly according to the extent and the disc. With appropriate indications,non- surgical treatment would have a well effect.