中文摘要：

目的 探讨经皮激光椎间盘减压术（PLDD）治疗腰椎间盘突出症的治疗效果,分析CT分级（Ⅰ、Ⅱ级）和临床分度（Ⅰ、Ⅱ、Ⅲ度）与激光照射量的相关性,研究PLDD治疗腰椎间盘突出症适宜的激光照射量.方法 收集2006年4月至2009年11月安徽医科大学合肥第三临床医院骨科46例腰椎间盘突出症患者,其中第4～5腰椎34例;第5腰椎至第1骶椎8例;第4～5腰椎和第1骶椎同时受压4例.依据CT分级分成CT Ⅰ组和CTⅡ级;每组间激光照射剂量比较采用两样本均数t检验;依据临床分度分成Ⅰ、Ⅱ、Ⅲ度,每度为一组,并对46例患者进行激光照射量的统计,每两组间激光照射剂量比较采用SNK-q检验;CT分级为Ⅰ级和Ⅱ级者疗效比较采用x2检验.同时对术后优良率进行统计;术前、术后腰痛及患肢痛VAS评分进行比较.结果 ①CT分级分成CT Ⅰ级组和CTⅡ级组,两组间激光照射剂量比较差异有统计学意义（P＜0.05）.②临床分度分成Ⅰ、Ⅱ、Ⅲ度,每两组间激光照射剂量比较差异无统计学意义（P＞0.05）.③CT分级分成CT Ⅰ级组和CTⅡ级组,两组间治疗效果比较差异无统计学意义（P＞0.05）.④采用的Macnab标准评定疗效：优31例,良6例,可7例,差2例,优良率为80％.腰痛及下肢痛VAS评分差异有统计学意义（P＜0.05）.结论 PLDD激光照射量CT Ⅰ级组剂量为500 J;CTⅡ级组剂量为600 ～710 J;激光照射剂量大小与临床症状和体征轻重无明显相关,与突出物大小相关;把握好激光照射量能明显改善VAS评分.

英文摘要：

Objective To study the effect of percutaneous laser disc decompression （PLDD） therapy on lumbar intervertebral disc protrusion,and to analyze the relationship between CT classification （Ⅰ,Ⅱ level） and clinical index （Ⅰ Ⅱ Ⅲ degree） and the appropriate laser irradiation dose.Methods In this hospital,46 patients with lumbar intervertebral disc protrusion were chose from April 2006 to November 2009,34 cases of L4 ～5,8 cases of Ls ～ s1,4 cases of L4～sand S1 at the same time.On the basis of CT results,the patients were divided into CT Ⅰ group and CT Ⅱ group; laser irradiation dose be of each group was compared by two sample mean t test; On the basis of clinical symptul,the patients were divided into Ⅰ,Ⅱ,Ⅲ degree,each in one group,and 46 cases all underwent laser irradiation dose,each laser irradiation dose between the two groups was compared by the SNK-q inspection; resalts of CT classification groups were compared by x2 test.At the same time on postoperative crop statistics; Preoperative and postoperative lumbar pain and limb pain VAS score were compared.Results ①Among CT Ⅰ group and CT Ⅱ group,the laser irradiation dose difference was signifitant （P 〈 0.05）.②Among clinical index groups,each laser irradiation dose has no obvious difference （P 〉 0.05）.③For CT Ⅰ group and CT Ⅱ group,the treatment effect between the two groups had no significant difference （P 〉 0.05）.④USES the Macnab criteria to assess efficacy of：31 cases were excellent,6 cases were good,7 cases were fair,2 cases were poor,and the excellent and good rate was 80%.Lumbago and leg pain VAS score had significant difference （P 〈 0.05）.Conclusions PLDD laser exposure level Ⅰ group CT dose in 500 J; CT Ⅱ group dose level between 600-710J; Laser irradiation dose size was not obvious related with clinical signs and symptoms,but was associated with protrusions size; control good laser exposure can significantly improve the VAS score.