PLD 联合腰背肌功能训练治疗腰椎间盘突出症疗效观察.docVIP

张宇虹 黄明勇 何松 湖北医药学院附属随州医院疼痛科，随州，441300  摘要 目的：观察经皮腰椎间盘摘除术（PLD）联合腰背肌功能训练治疗腰椎间盘突出 症的治疗效果。方法：腰椎间盘突出症患者730临床病例，随机分为治疗组和对照组。 对照组行PLD+局部理疗，治疗组在此基础上给予腰背肌功能训练,记录治疗前和治疗后 1、7、14、30d的疼痛VAS评分、1年随访复发率。结果：两组1月后VAS评分没有显著差 异，但1年随访治疗组复发率明显低于对照组。结论：腰背肌功能训练有助于降低PLD 术后腰椎间盘突出症的复发率低，提高远期效果。 关键词：腰背肌功能训练；椎间盘切除术;经皮；腰椎间盘突出症 责任作者与联系方式：黄明勇，E-mail: hnu-7@163.com PLD联合腰背肌功能训练治疗腰椎间盘突出 症疗效观察 The Clinical Effects OF PLD Combined Lumbar Back Muscle Function Training Treatment of Lumbar Intervertebral Disc Herniation Yu-hong Zhang, Ming-yong Huang, Song He Department of Pain Management, Suizhou Hospital Affiliated to Hubei Medical College, Suizhou 441300 Abstract Objective: To observe the clinic effects of percutaneous lumbar diskectomy (PLD) combined back muscle function training treatment of lumbar intervertebral disc herniation. Methods: 730 patients with lumbar intervertebral disc herniation clinical cases, random divided into treatment group and control group. Control group did PLD + local physical therapy, treatment group was given based on the back muscle function training, record before treatment and after treatment 1, 7, 14, 30 d pain VAS score, 1 year follow-up the recurrence rate. Results: Two groups after 1 month of VAS score no significant difference, but 1 year follow-up recurrence rate in treatment roup was obviously lower compared group. Conclusions: Lumbar back muscle function training help reduce PLD postoperative lumbar intervertebral disc herniation of the recurrence rate is low, improve the long-term effect. Key Words: Back muscle training; Diskectomy; Percutaneous; Lumbar intervertebral disc herniation Corresponding Author: Ming-yong Huang, E-mail: hnu-7@163.com  腰椎间盘突出症是引起腰腿痛的临床常见病种之一，我 们于1999年5月运用自动旋切式椎间盘摘除器在X线监视下行 经皮腰椎间盘摘除术（percutaneous lumbar diskectomy, P L D）[1]治疗腰椎间盘突出症。为了提高治疗效果和降低复 发率，我们结合运动医学的观念，设计应用腰背肌功能训练 干预治疗，报道如下： 一、治疗方法 两组均行PLD治疗，治疗组同时行腰背肌功能训练。 图1 体位 Figure 1 Body positon  1.PLD 采用自动旋切式腰椎间盘摘除器先进行摘除术。患者侧 卧在手术台上，患侧在上，腰部垫枕，患侧下肢过伸位（见 图1）。在日本岛津750型X线机监视下，透视下分别确定穿 刺点