患肢屈髋位牵引治疗急性期单侧型腰椎间盘突出的临床研究

Clinical research on treating unilateral prolapsed of lumbar intervertebral disc in acute stage with lumbar traction in affected limb with hip flection

目的:观察患肢屈髋位牵引治疗急性期单侧型腰椎间盘突出的临床疗效及其对患侧神经根周围脂肪CT值的影响。方法:将100例急性期单侧型腰椎间盘突出患者随机分为两组,每组各50例。两组在给予相同基础治疗的同时,观察组予患肢屈髋位牵引,对照组予水平位骨盆牵引。比较两组JOA评分、患侧神经根周围脂肪CT值,并分析JOA评分与CT值的相关性。结果:JOA评分,观察组整体效果优于对照组(P<0.05)。在2周治疗期间,观察组改善趋势优于对照组(P<0.05)。3个月后随访两组改变趋势均较稳定,组间差异不明显。神经根周围脂肪CT值,观察组显著优于对照组(P<0.01)。JOA评分与CT值绝对值具有较显著的的相关性(P<0.01)。结论:对于急性期单侧型腰椎间盘突出,患肢屈髋位牵引较水平位骨盆牵引整体疗效更好,起效更快。神经根周围脂肪CT值可以作为评价神经根炎性反应水平的客观化量化指标。

Objective：To observe the clinical effect of treating unilateral prolapsed of lumbar intervertebral disc in acute stage with lumbar traction in affected limb with hip flection and its influence on the CT value of adipose tissue around the nerve root of affected limb.Methods：100 patients with unilateral prolapsed of lumbar intervertebral disc in acute stage were randomly divided into two groups with 50 cases in each group.Patients in observation group received treatment of lumbar traction in affected limb with hip flection,and patients in control group received pelvis traction in horizontal position based on the same basic treatment.The JOA score and CT value of adipose tissue around the nerve root of affected limb of patients in the two groups were compared and analyzed.Results：The overall effect in JOA score of patients in observation group was superior to that of control group（P〈0.05）.The improvement tendency of patients in observation group during treatment period was superior to that of patients in control group（P〈0.05）.CT value of adipose tissue around the nerve root of patients in observation group was superior to that of control group（P〈0.01）.There was significant correlation between absolute values of JOA score and CT value（P〈0.01）.Conclusion：The curative effect of lumbar traction in affected limb with hip flection in treating unilateral prolapsed of lumbar intervertebral disc in acute stage was better that that of pelvis traction in horizontal position,and the CT value of adipose tissue around the nerve root cloud be as the objective quantitative indicator to evaluate the nerve root inflammation levels.