经皮激光气化减压术治疗腰椎间盘突出症不同输出功率疗效的比较

Percutaneous Laser Gasification Decompression for the Treatment of Lumbar Disc Herniation with Different Laser Output Power

目的探讨不同激光输出功率对经皮激光椎间盘汽化减压术(percutancous laser disc decompression,PLDD)治疗腰椎间盘突出症的作用。方法回顾性分析2015年2月至2016年6月,单节段腰椎间盘突出症患者63例,根据不同的功率10 W(A组)、15 W(B组)、20 W(C组)随机分为三组,每组21例患者,进行PLDD治疗,激光总能量3 500 J。记录术中激光手术的时间、术中出现不适症状次数,比较分析三组患者术前、术后1周、术后3个月时ODI功能障碍评价(Oswestry disability index,ODI)。结果 A、B和C组患者PLDD手术时间分别(8.90±1.3)min、(6.48±0.9)min和(5.76±0.9)min,A组与B、C组比较,差异具有统计学意义(P<0.05)。A、B和C组患者术中出现不适症状次数分别为(0.71±0.6)次、(1.24±0.7)次和(2.62±1.0)次,A、B两组比较,差异无统计学意义(P>0.05),A、B两组与C组比较,差异具有统计学意义(P<0.05)。三组术前、术后3个月ODI评分进行组间比较,差异无统计学意义(P>0.05);术后1周A、B组与C组比较,差异均具有统计学意义(P<0.05);不同时间点A、B和C组ODI评分进行组内比较,均具有统计学意义(P<0.05)。结论采用激光输出功率15 W时,进行PLDD治疗腰椎间盘突出症具有缩短治疗时间、减少治疗过程中出现的不适症状、术后短期内患者症状较快缓解等优势。

Objective To investigate the effect of different laser output power on percutancous laser disc decompression（PLDD） in the treatmentof lumbar disc protrusion.Methods Patients who to receive PLDD treatment of lumbar disc protrusion in our hospital were randomly divided into A,B,C three groups from February 2015 to June 2016,being given 10 W,15 W,20 W output with PLDD treatment respectively,we observate the time of intraoperative treatment,the number of patients who have discomfort symptoms during the operation and the Oswestry disability index with patients in preoperation、postoperative 1 week and postoperative 3 months,moreorer,we record the related data and have comparison analysis.Results The required surgeny time for A,B,C group were（A： 8. 90 ± 1. 26,B： 6. 48 ± 0. 87,C： 5. 76 ± 0. 89） respectively,Compared with B,C groups,A has statistically（P 〈0. 05）; the number of having uncomfortable symptoms were（A： 0. 71 ± 0. 64,B： 1. 24 ± 0. 70,C： 2. 62 ± 1. 02） difference,and there was no statistical difference between A and B groups. However,there was statisticant difference between A,B groups and C group（P 〈0. 05）; ODI scores were compared between groups before and 3 months after operation. The difference was not statistically significant（P 〉0. 05）. At one week after surgery,there was significant difference between group A and group B and group C（P 〈0. 05）; ODI scores of groups A,B and C at different time points were performed. Within the group,there was statistically difference（P 〈0. 05）.Conclusions PLDD treatment of lumbar disc protrusion with the laser output power of 15 W can shorten the treatment time are reduce the discomfort symptoms during treatment,promote the patient＇s symptoms to relieve rapidly in short-term postoperative.