\u6765\u6e90\uff1a\u300a\u9888\u8170\u75db\u6742\u5fd7\u300b<\/p>\n
\u901a\u4fe1\u4f5c\u8005\uff1a\u9655\u897f\u7701\u4eba\u6c11\u533b\u9662\u9aa8\u79d1 \u9773\u5360\u594e<\/p>\n
\u8170\u690e\u95f4\u76d8\u7a81\u51fa\u75c7\uff08lumbar disc herniation, LDH\uff09\u5728\u9aa8\u79d1\u75be\u75c5\u4e2d\u6781\u4e3a\u5e38\u89c1\uff0c\u5176\u75c7\u72b6\u4e3b\u8981\u4f53\u73b0\u4e3a\u8170\u75db\uff64\u4e0b\u80a2\u53cd\u5c04\u75db\uff64\u9ebb\u6728\u4ee5\u53ca\u9a6c\u5c3e\u795e\u7ecf\u7efc\u5408\u5f81\u7b49\uff61\u60a3\u75c5\u7387\u4e3a1%-3%\uff0c\u53d1\u75c5\u5e74\u9f84\u591a\u4e3a30-50\u5c81\uff61<\/p>\n
\u56e0\u4e3a\u5176\u5178\u578b\u75c7\u72b6\u660e\u663e\uff0c\u518d\u914d\u5408\u4f53\u683c\u68c0\u67e5\uff64\u5f71\u50cf\u5b66\u68c0\u67e5\uff0c\u5982CT\uff64MRI\u663e\u793a\u690e\u95f4\u76d8\u7a81\u51fa\u60c5\u51b5\u5373\u53ef\u7efc\u5408\u5224\u65ad\uff0c\u6240\u4ee5LDH\u7684\u8bca\u65ad\u5e76\u4e0d\u96be\uff61\u53e6\u5916\uff0c\u8fd1\u5e74\u6765\u968f\u7740\u810a\u67f1\u5fae\u521b\u624b\u672f\u5728\u5404\u7ea7\u533b\u9662\u7684\u666e\u53ca\uff0cLDH\u7684\u8bca\u7597\u8fbe\u5230\u524d\u6240\u672a\u6709\u7684\u9ad8\u6c34\u5e73\uff0c\u56e0\u800c\u4ece\u8868\u9762\u4e0a\u6765\u770b\uff0cLDH\u8fd9\u4e00\u75be\u75c5\u5f88\u5c11\u6f0f\u8bca\uff61<\/p>\n
\u4f46\u6df1\u5165\u5256\u6790\u5c31\u4f1a\u53d1\u73b0\u5728\u4e34\u5e8a\u4e0a\u4e00\u4e9bLDH\u7684\u6cbb\u7597\u8fc7\u7a0b\u5e76\u975e\u603b\u80fd\u6309\u7167\u9884\u671f\u7ebf\u6027\u63a8\u8fdb\uff0c\u5176\u4e2d\u5b58\u5728\u8bf8\u591a\u201c\u9677\u9631\u95ee\u9898\u201d\u5bfc\u81f4\u8bef\u8bca\uff61<\/p>\n
\u672c\u6587\u5c31LDH\u6613\u6df7\u6dc6\u76845\u79cd\u75be\u75c5\uff1aBertolotti’s\u7efc\u5408\u5f81\uff64\u8fdc\u5916\u4fa7\u7efc\u5408\u5f81\uff64\u6781\u5916\u4fa7\u690e\u95f4\u76d8\u7a81\u51fa\uff64\u68d8\u7a81\u95f4\u9aa8\u5173\u8282\u75c5\uff64\u9acb\u5173\u8282\u76f8\u5173\u75be\u75c5\u5c55\u5f00\u5168\u9762\u800c\u7ec6\u81f4\u7684\u7efc\u8ff0\uff61<\/p>\n
\u9677\u9631\u4e00\uff1aBertolotti’s\u7efc\u5408\u5f81<\/p>\n
1.1 \u6982\u8ff0<\/p>\n
Bertolotti’s\u7efc\u5408\u5f81[1]<\/sup>\u662f\u7531\u8170\u9ab6\u79fb\u884c\u690e\uff08lumbosacral transitional vertebra, LSTV\uff09\u5f15\u53d1\u7684\u6162\u6027\u8170\u817f\u75db\u75be\u75c5\uff0c\u4e24\u8005\u867d\u5747\u8868\u73b0\u4e3a\u4e0b\u8170\u75db\u53ca\u4e0b\u80a2\u653e\u5c04\u75db\uff0c\u4f46\u53d1\u75c5\u673a\u5236\u5b58\u5728\u672c\u8d28\u5dee\u5f02[2-3]<\/sup>\uff1aBertolotti’s\u7efc\u5408\u5f81\u6e90\u4e8eL5\/S1\u4ea4\u754c\u533a\u9aa8\u6027\u7ed3\u6784\u5f02\u5e38\uff08\u5982L5\u6a2a\u7a81\u80a5\u5927\u4e0e\u9ab6\u9aa8\u5f62\u6210\u5047\u5173\u8282\u6216\u5b8c\u5168\u878d\u5408\uff09\u5bfc\u81f4\u7684\u690e\u95f4\u5b54\u5916\u53e3\u72ed\u7a84\u53ca\u795e\u7ecf\u6839\u5361\u538b[4]<\/sup>\uff0c\u800cLDH\u5219\u7531\u690e\u95f4\u76d8\u9000\u53d8\u7a81\u51fa\u76f4\u63a5\u538b\u8feb\u795e\u7ecf\u6839\u5f15\u8d77\uff61<\/p>\n \u5f71\u50cf\u5b66\u8bca\u65ad\u65f6\u9700\u91cd\u70b9\u5173\u6ce8LSTV\u7684\u7279\u5f81\u6027\u6539\u53d8\uff0c\u8170\u690e\u9ab6\u5316\u548c\u9ab6\u690e\u8170\u5316\uff08\u56fe1\uff09\uff0c\u4e24\u79cd\u53d8\u5f02\u5747\u5bfc\u81f4\u8170\u690e\u6a2a\u7a81\u80a5\u5927\u6216\u7ffc\u72b6\u6539\u53d8\uff0c\u53ef\u80fd\u4e0e\u9ab6\u9aa8\u6216\u9ac2\u9aa8\u5f62\u6210\u5047\u5173\u8282\uff0c\u6210\u4e3a\u75bc\u75db\u7684\u89e3\u5256\u5b66\u57fa\u7840\uff0c\u8fd8\u5305\u62ec\u8170\u690e\u603b\u6570\u53d8\u5f02\uff08L4\u6216L6\uff09\uff64\u6a2a\u7a81-\u9ab6\u9aa8\u5f02\u5e38\u8fde\u63a5\u7ed3\u6784\u4ee5\u53ca\u690e\u95f4\u5b54\u5916\u53e3\u9aa8\u6027\u72ed\u7a84\uff0c\u6613\u5bfc\u81f4\u201c\u8d23\u4efb\u75c5\u7076\u201d\u8bef\u5224\uff61<\/p>\n \u56fe1 \u8170\u690eX\u7ebf\u7247<\/p>\n A\uff64B\uff1a\u6b63\u4f4dX\u7ebf\u7247\u548c\u4fa7\u4f4d\u7247\uff0c\u53ef\u89c1\u9ab6\u690e\u8170\u5316\uff08\u7b2c1\u9ab6\u690e\u672a\u4e0e\u9ab6\u9aa8\u878d\u5408\uff0c\u5f62\u6210\u201c\u7b2c6\u8170\u690e\u201d\uff09<\/p>\n \u4e34\u5e8a\u5b9e\u8df5\u4e2d\uff0c\u82e5\u4ec5\u5904\u7406\u690e\u95f4\u76d8\u7a81\u51fa\u800c\u5ffd\u7565\u6a2a\u7a81\u80a5\u5927\u9020\u6210\u7684\u9aa8\u6027\u5361\u538b\uff0c\u672f\u540e\u6b8b\u7559\u795e\u7ecf\u75c7\u72b6\u53d1\u751f\u7387\u53ef\u8fbe35%[5]<\/sup>\uff61\u56e0\u6b64\u9700\u7ed3\u5408Castellvi\u5206\u578b\u7cfb\u7edf\u8bc4\u4f30LSTV\u4e25\u91cd\u7a0b\u5ea6\uff0c\u5e76\u901a\u8fc7\u9009\u62e9\u6027\u795e\u7ecf\u6839\u963b\u6ede\uff64\u4e09\u7ef4CT\u91cd\u5efa\u53caMR\u795e\u7ecf\u6210\u50cf\u6280\u672f\u7cbe\u51c6\u5b9a\u4f4d\u795e\u7ecf\u53d7\u538b\u90e8\u4f4d\uff0c\u907f\u514d\u56e0\u6f0f\u8bca\u5f15\u53d1\u4e8c\u6b21\u624b\u672f\u98ce\u9669\uff61<\/p>\n 1.2 \u8bca\u65ad\u6807\u51c6\u4e0e\u5f71\u50cf\u5b66\u7279\u5f81<\/p>\n Bertolotti’s\u7efc\u5408\u5f81\u4f5c\u4e3aLSTV\u5f15\u53d1\u7684\u7279\u6b8a\u75c7\u5019\u7fa4\uff0c\u5728\u4e0d\u540c\u5e74\u9f84\u5c42\u4eba\u7fa4\u4e2d\u8868\u73b0\u51fa\u660e\u663e\u7684\u60a3\u75c5\u7387\u5f02\u8d28\u6027\uff084.0%~10%\uff09[6]<\/sup>\uff0c\u9752\u5c11\u5e74\uff0815.7%\u4e3a11~20\u5c81\uff09\u548c\u4e2d\u8001\u5e74\uff0822.5%\u4e3a31~40\u5c81\uff09\u5747\u9ad8\u53d1[7]<\/sup>\uff61<\/p>\n \u5c3d\u7ba1\u5927\u591a\u6570LSTV\u60a3\u8005\u65e0\u75c7\u72b6\uff0c\u4f46\u5f02\u5e38\u7684\u8170\u9ab6\u90e8\u751f\u7269\u529b\u5b66\u7279\u6027\u53ef\u5bfc\u81f4\u8fd0\u52a8\u6a21\u5f0f\u7d0a\u4e71\u548c\u5e94\u529b\u5206\u5e03\u5931\u8861\uff0c\u5f53\u6a2a\u7a81\u80a5\u5927\u5f15\u53d1\u690e\u95f4\u5b54\u72ed\u7a84\u53ca\u795e\u7ecf\u6839\u538b\u8feb\u65f6\uff0c\u5219\u51fa\u73b0\u7279\u5f81\u6027L5\u795e\u7ecf\u6839\u75c7\u72b6\uff61Castellvi\u5206\u7c7b\u7cfb\u7edf[8]<\/sup>\u4f9d\u636e\u6a2a\u7a81\u5f62\u6001\u5b66\u7279\u5f81\u5c06LSTV\u5206\u4e3a\u56db\u578b\uff08\u88681\uff09\uff1a\u2160\u578b\uff08\u6a2a\u7a81\u5bbd\u5ea6\u226519mm\uff09\uff64\u2161\u578b\uff08\u5047\u5173\u8282\u5f62\u6210\uff09\uff64\u2162\u578b\uff08\u9ab6\u9aa8\u5b8c\u5168\u878d\u5408\uff09\u53ca\u2163\u578b\uff08\u6df7\u5408\u578b\uff09\uff0c\u89c1\u56fe2-\u56fe6\uff61\u4e34\u5e8a\u89c2\u5bdf\u53d1\u73b0\u2161\u578b\u5047\u5173\u8282\u9000\u53d8\u662f\u8bf1\u53d1\u4e0b\u8170\u75db\u7684\u4e3b\u8981\u75c5\u7406\u7c7b\u578b[9]<\/sup>\uff61<\/p>\n \u88681 LSTV\u5206\u578b<\/p>\n \u56fe2 LSTV\u5206\u578b\u793a\u610f\u56fe<\/p>\n \u56fe3 LSTV\u2161B\u578b<\/p>\n A-D\uff1aLSTV\u2161B\u578b\u4f8b\uff0c\u8868\u73b0\u4e3a\u53cc\u4fa7\u6a2a\u7a81\u80a5\u5927\uff0c\u5373\u8170\u690e\u6b63\u4f4d\u7247\u4e2d\u53ef\u89c1\u6a2a\u7a81\u5bbd\u5ea6\u6d4b\u91cf\u226519mm<\/p>\n \u56fe4 LSTV\u2161A\u548c\u2161B\u578b<\/p>\n A\uff64B\uff1a\u2161A\u578b\u5355\u4fa7\u6a2a\u7a81\u4e0e\u9ab6\u9aa8\u5f62\u6210\u5047\u5173\u8282\uff1bC\uff1a\u2161B\u578b\u53cc\u4fa7\u6a2a\u7a81\u4e0e\u9ab6\u9aa8\u5f62\u6210\u5047\u5173\u8282<\/p>\n \u56fe5 LSTV\u2162A\u578b\u548c\u2162B\u578b<\/p>\n A\uff1a\u2162A\u578b\u5355\u4fa7\u6a2a\u7a81\u4e0e\u9ab6\u9aa8\u5b8c\u5168\u878d\u5408\uff1bB\uff1a\u2162B\u578b\u53cc\u4fa7\u6a2a\u7a81\u4e0e\u9ab6\u9aa8\u5b8c\u5168\u878d\u5408<\/p>\n \u56fe6 LSTV \u2163\u578b<\/p>\n \u2163\u578b\uff1a\u4e00\u4fa7\u4e3a\u2161\u578b\uff0c\u53e6\u4e00\u4fa7\u4e3a\u2162\u578b<\/p>\n 1.3 \u6cbb\u7597<\/p>\n Bertolotti’s\u7efc\u5408\u5f81\u7684\u53d1\u75c5\u673a\u5236\u5c1a\u672a\u5b8c\u5168\u9610\u660e\uff0c\u76ee\u524d\u8ba4\u4e3a\u5176\u75c5\u7406\u8fc7\u7a0b\u6d89\u53ca\u591a\u91cd\u673a\u5236\uff1a\u2460LSTV\u4e0a\u65b9\u690e\u95f4\u76d8\u52a0\u901f\u9000\u53d8\u5f15\u53d1\u7684\u690e\u7ba1\u72ed\u7a84\u53ca\u690e\u95f4\u76d8\u7a81\u51fa\uff1b\u2461\u5047\u5173\u8282\u5931\u7a33\u5bfc\u81f4\u7684\u810a\u67f1\u9000\u884c\u6027\u5173\u8282\u708e\uff0c\u5c24\u5176\u5355\u4fa7\u5f02\u5e38\u8fde\u63a5\u5f15\u8d77\u7684\u751f\u7269\u529b\u5b66\u5931\u8861\u53ef\u7ee7\u53d1\u5bf9\u4fa7\u5c0f\u5173\u8282\u9000\u53d8\uff1b\u2462\u6a2a\u7a81\u80a5\u5927\u76f4\u63a5\u9020\u6210L5\u795e\u7ecf\u6839\u51fa\u53e3\u533a\u9aa8\u6027\u5361\u538b\uff61\u4e34\u5e8a\u6cbb\u7597\u9700\u7cbe\u51c6\u8bc6\u522b\u75bc\u75db\u6765\u6e90\uff0c\u4fdd\u5b88\u6cbb\u7597\u4e0e\u5c04\u9891\u6d88\u878d\u7597\u6548\u6709\u9650\uff0c\u624b\u672f\u5e72\u9884\u6210\u4e3a\u91cd\u8981\u9009\u62e9[10]<\/sup>\uff61<\/p>\n Mikula\u7b49[11]<\/sup>\u5bf9\u6bd4\u5173\u8282\u5207\u9664\u672f\u4e0e\u878d\u5408\u672f\u53d1\u73b0\uff0c\u540e\u8005\u5728\u8fdc\u671f\u75bc\u75db\u63a7\u5236\u66f4\u5177\u4f18\u52bf\uff1b\u51c6\u786e\u8bca\u65ad\u75bc\u75db\u6765\u6e90\u5bf9Bertolotti’s\u7efc\u5408\u5f81\u7684\u6cbb\u7597\u53ca\u672f\u5f0f\u9009\u62e9\u8d77\u7740\u81f3\u5173\u91cd\u8981\u7684\u4f5c\u7528\uff0c\u800c\u8bca\u65ad\u6027\u6ce8\u5c04\u5bf9\u4e8e\u5224\u5b9aLSTV\u662f\u5426\u4e3a\u81f4\u4f7f\u60a3\u8005\u8170\u75db\u548c\u6839\u6027\u75c7\u72b6\u7684\u6839\u6e90\uff0c\u8fd9\u4e00\u70b9\u5c24\u4e3a\u5173\u952e\uff61Li\u7b49[12]<\/sup>\u91c7\u7528\u7684\u5229\u591a\u5361\u56e0\/\u6fc0\u7d20\u5c01\u95ed\u8bd5\u9a8c\u662f\u9274\u522b\u75bc\u75db\u6765\u6e90\u7684\u5173\u952e\u6280\u672f\uff0c\u9633\u6027\u7ed3\u679c\u53ef\u6307\u5bfc\u5fae\u521b\u6a2a\u7a81\u5207\u9664\u672f\u7684\u5b9e\u65bd\uff61\u5f53\u524d\u624b\u672f\u7597\u6548\u5b58\u5728\u663e\u8457\u4e2a\u4f53\u5dee\u5f02\uff0c\u4e9f\u9700\u901a\u8fc7\u524d\u77bb\u6027\u5927\u6837\u672c\u7814\u7a76\u4f18\u5316\u672f\u5f0f\u9009\u62e9\u6807\u51c6\uff0c\u4ee5\u63d0\u5347\u6cbb\u7597\u7cbe\u51c6\u5ea6\u4e0e\u60a3\u8005\u9884\u540e\uff61<\/p>\n \u9677\u9631\u4e8c\uff1a\u8fdc\u5916\u4fa7\u7efc\u5408\u5f81\/\u8fdc\u7aef\u7efc\u5408\u5f81<\/p>\n 2.1 \u6982\u8ff0<\/p>\n \u8fdc\u7aef\u7efc\u5408\u5f81\/\u8fdc\u5916\u4fa7\u7efc\u5408\u5f81\uff08far out syndrome, FOS\uff09\u53c8\u540d\u690e\u95f4\u5b54\u5916\u5d4c\u538b\u6216\u690e\u95f4\u5b54\u51fa\u53e3\u533a\u72ed\u7a84\uff0c\u662fL5\u795e\u7ecf\u6839\u5728\u80a5\u5927\u7684L5\u6a2a\u7a81\u4e0e\u9ab6\u9aa8\u7ffc\u4e4b\u95f4\u7684\u690e\u95f4\u5b54\u5916\u533a\u57df\u5730\u53d7\u5230\u538b\u8feb\u548c\u5361\u538b\uff0c\u89c1\u56fe7\uff0c\u6700\u65e9\u7531Wiltse\u7b49[13]<\/sup>\u4e8e1984\u5e74\u8fdb\u884c\u63cf\u8ff0\uff61Wiltse\u8ba4\u4e3a\u8fdc\u7aef\u7efc\u5408\u5f81\u6709\u4e24\u79cd\u7c7b\u578b\uff1aI\u578b\u662f\u591a\u89c1\u4e8e\u60a3\u6709\u9000\u884c\u6027\u8170\u690e\u4fa7\u51f8\u7684\u8001\u5e74\u4eba\uff0c\u2161\u578b\u591a\u89c1\u4e8e\u8f83\u5e74\u8f7b\u7684\u6210\u5e74\u4eba\uff0c\u4f34\u6709\u5ce1\u90e8\u6ed1\u8131\u548c\u81f3\u5c1120%\u7684\u6ed1\u79fb\uff61<\/p>\n \u56fe7 L4-L5\u795e\u7ecf\u6839\u5728\u79bb\u5f00\u690e\u95f4\u5b54\u540e\u7684\u8fdc\u7aef\u8d70\u884c\u4e2d\u53d7\u5230\u673a\u68b0\u6027\u538b\u8feb<\/p>\n 2.2 \u8bca\u65ad\u6807\u51c6\u4e0e\u5f71\u50cf\u5b66\u7279\u5f81<\/p>\n FOS\u7684\u60a3\u8005\u548cLDH\u7684\u4e34\u5e8a\u8868\u73b0\u7c7b\u4f3c\uff0c\u4e5f\u4f1a\u51fa\u73b0\u4e0b\u80a2\u653e\u5c04\u6027\u75bc\u75db\uff64\u9ebb\u6728\u7b49\u75c7\u72b6\uff0c\u56e0\u810a\u795e\u7ecf\u6839\u53d7\u538b\u523a\u6fc0\u5176\u652f\u914d\u533a\u57df\u611f\u89c9\u795e\u7ecf\uff0c\u8be5\u533a\u57df\u8fd8\u53ef\u80fd\u51fa\u73b0\u611f\u89c9\u51cf\u9000\uff64\u9ebb\u6728\u6216\u523a\u75db\u7b49\u5f02\u5e38\uff0c\u5bfc\u81f4\u4e0b\u80a2\u808c\u8089\u529b\u91cf\u51cf\u5f31\u7b49\u8fd0\u52a8\u529f\u80fd\u969c\u788d\uff61\u5f53LDH\u4e0eFOS\u5171\u5b58\u65f6\uff0cFOS\u7684\u4e34\u5e8a\u75c7\u72b6\u53ef\u80fd\u88ab\u9519\u8bef\u5f52\u56e0\u4e8eLDH\uff0c\u8fdb\u800c\u5bfc\u81f4\u6cbb\u7597\u7b56\u7565\u504f\u5dee\uff61\u4f8b\u5982\uff0c\u5355\u7eaf\u884c\u690e\u95f4\u76d8\u5207\u9664\u672f\u53ef\u80fd\u65e0\u6cd5\u7f13\u89e3\u690e\u95f4\u5b54\u5916\u795e\u7ecf\u538b\u8feb\uff0c\u81f4\u4f7f\u672f\u540e\u6b8b\u7559\u4e0b\u80a2\u653e\u5c04\u75db\u6216\u808c\u529b\u51cf\u9000\uff0c\u663e\u8457\u5f71\u54cd\u60a3\u8005\u9884\u540e\uff61<\/p>\n \u7efc\u5408\u4e34\u5e8a\u8868\u73b0\uff64\u4f53\u683c\u68c0\u67e5\u53ca\u591a\u6a21\u6001\u5f71\u50cf\u5b66\u7279\u5f81\uff08\u89c1\u56fe8\uff09\uff1a\u5178\u578b\u75c7\u72b6\u5305\u62ec\u6839\u6027\u653e\u5c04\u75db\u53ca\u795e\u7ecf\u652f\u914d\u533a\u611f\u89c9\u8fd0\u52a8\u969c\u788d\uff0cMRI\u810a\u795e\u7ecf\u6839\u5f25\u6563\u5f20\u91cf\u6210\u50cf\uff08diffusion tensor imaging, DTI\uff09\u53ef\u4e09\u7ef4\u53ef\u89c6\u5316\u795e\u7ecf\u6839\u5728\u690e\u7ba1\uff64\u690e\u95f4\u5b54\u53ca\u690e\u95f4\u5b54\u5916\u533a\u57df\u7684\u53d7\u538b\u60c5\u51b5\uff0c\u4e09\u7ef4CT\u80fd\u7cbe\u786e\u8bc4\u4f30\u9aa8\u6027\u72ed\u7a84\u5bf9\u795e\u7ecf\u6839\u51fa\u53e3\u7684\u5361\u538b\u7a0b\u5ea6\uff0cX\u7ebf\u5219\u7528\u4e8e\u7b5b\u67e5\u5148\u5929\u6027\u7578\u5f62\uff08\u5982\u690e\u4f53\u878d\u5408\uff09\u53ca\u9000\u53d8\u6027\u6539\u53d8\uff08\u9aa8\u8d28\u589e\u751f\uff64\u690e\u95f4\u9699\u72ed\u7a84\u7b49\uff09\uff61<\/p>\n \u56fe8 \u60a3\u8005\uff0c\u5973\uff0c48\u5c81\uff0c\u8170\u75db\u4f34\u53f3\u4e0b\u80a2\u75bc\u75db7\u4e2a\u6708\uff61\u53f3\u4e0b\u80a2\u76f4\u817f\u62ac\u9ad8\u8bd5\u9a8c\uff08+\uff09\uff64\u52a0\u5f3a\u8bd5\u9a8c\uff08-\uff09\uff0c\u53f3\u8db3\u80cc\u6d45\u611f\u89c9\u8f83\u5bf9\u4fa7\u51cf\u5f31\uff0c\u53cc\u4e0b\u80a2\u808c\u5f20\u529b\u6b63\u5e38<\/p>\n A\uff1a\u8170\u690eMRI\uff1bB\uff1a\u8170\u690eCT\u53ef\u89c1L5-S1\u690e\u4f53\u540e\u7f18\u9aa8\u8d58\u751f\u6210\uff0c\u690e\u95f4\u5b54\u76f8\u5bf9\u72ed\u7a84\u5bfc\u81f4L5\u795e\u7ecf\u6839\u53d7\u5230\u5361\u538b<\/p>\n 2.3 \u6cbb\u7597<\/p>\n \u6cbb\u7597\u9700\u9075\u5faa\u9636\u68af\u5316\u539f\u5219\uff0c\u5bf9\u4e8e\u65e9\u671f\u6709\u75c7\u72b6\u7684\u60a3\u8005\uff0c\u7ecf\u690e\u95f4\u5b54\u786c\u819c\u5916\u7c7b\u56fa\u9187\u6ce8\u5c04\uff08transforamial epidural steroid injection, TFSI\uff09\u53ef\u6709\u6548\u7f13\u89e3\u75bc\u75db\uff0cSerifoglu\u7b49[14]<\/sup>\u7814\u7a76\u663e\u793a\u6cbb\u7597\u540e3\u4e2a\u6708\u5185\u75bc\u75db\u89c6\u89c9\u6a21\u62df\u8bc4\u5206\uff08visual analogue scale, VAS\uff09\u5448\u4e0b\u964d\u8d8b\u52bf\uff0c\u529f\u80fd\u6d3b\u52a8\u663e\u8457\u6062\u590d\uff1b\u4fdd\u5b88\u6cbb\u7597\u65e0\u6548\u6216\u5b58\u5728\u4e25\u91cd\u673a\u68b0\u538b\u8feb\u8005\u9700\u624b\u672f\u5e72\u9884\uff0cHa\u7b49[15]<\/sup>\u91c7\u7528\u5355\u4fa7\u53cc\u901a\u9053\u5185\u955c\uff08unilateral biportal endoscopy, UBE\uff09\u6280\u672f\u884c\u5fae\u521b\u51cf\u538b\uff0c\u672f\u540e2\u5e74VAS\u8bc4\u5206\u964d\u81f30\u5206\uff0c\u81c0\u90e8\u548c\u4e0b\u80a2Oswestry\u529f\u80fd\u969c\u788d\u6307\u6570\uff08Oswestry disability index, ODI\uff09\u6539\u5584\u81f310%\uff0c\u8bc1\u5b9e\u8be5\u6280\u672f\u517c\u5177\u7cbe\u51c6\u51cf\u538b\u4e0e\u7ec4\u7ec7\u4fdd\u62a4\u4f18\u52bf\uff61\u9700\u5f3a\u8c03\u672f\u5f0f\u9009\u62e9\u5e94\u4e2a\u4f53\u5316\uff1a\u5355\u7eaf\u795e\u7ecf\u538b\u8feb\u9996\u9009UBE\u7b49\u5fae\u521b\u672f\u5f0f\uff0c\u800c\u5408\u5e76\u690e\u95f4\u5931\u7a33\u8005\u9700\u8054\u5408TLIF\u7b49\u878d\u5408\u6280\u672f\uff0c\u4e34\u5e8a\u51b3\u7b56\u9700\u6743\u8861\u795e\u7ecf\u51cf\u538b\u5145\u5206\u6027\uff64\u810a\u67f1\u7a33\u5b9a\u6027\u53ca\u60a3\u8005\u529f\u80fd\u9700\u6c42\uff61<\/p>\n \u9677\u9631\u4e09\uff1a\u6781\u5916\u4fa7\u690e\u95f4\u76d8\u7a81\u51fa<\/p>\n 3.1 \u6982\u8ff0<\/p>\n \u6781\u5916\u4fa7\u578b\u8170\u690e\u95f4\u76d8\u7a81\u51fa\u75c7\uff08far lateral lumbar disc herniation, FLLDH\uff09\u662fLDH\u8f83\u4e3a\u7279\u6b8a\u7684\u4e00\u79cd\u7c7b\u578b[16]<\/sup>\uff0c\u8868\u73b0\u4e3a\u7a81\u51fa\u7684\u9ad3\u6838\u4f4d\u4e8e\u690e\u5f13\u6839\u5185\u5916\u7f18\u4e4b\u95f4\u6216\u5904\u4e8e\u690e\u95f4\u5b54\u4ee5\u5916\uff61\u8fd9\u79cd\u7a81\u51fa\u4f1a\u538b\u8feb\u540c\u8282\u6bb5\u795e\u7ecf\u6839\uff0c\u8fdb\u800c\u5f15\u53d1\u4e0b\u80a2\u653e\u5c04\u6027\u75bc\u75db\uff0c\u75bc\u75db\u8303\u56f4\u6b63\u662f\u8be5\u795e\u7ecf\u6839\u6240\u652f\u914d\u7684\u533a\u57df\uff61\u8be5\u75be\u75c5\u7684\u75c7\u72b6\u8868\u73b0\u5177\u6709\u4e00\u5b9a\u7279\u6b8a\u6027\uff0c\u901a\u5e38\u4ee5\u810a\u795e\u7ecf\u6839\u6240\u652f\u914d\u7684\u533a\u57df\u75bc\u75db\u4e3a\u4e3b\u8981\u7279\u5f81\uff0c\u800c\u8170\u90e8\u75bc\u75db\u76f8\u5bf9\u4e0d\u663e\u8457\uff61<\/p>\n \u5176\u7a81\u51fa\u4f4d\u7f6e\u7684\u72ec\u7279\u6027\uff0c\u4f7f\u5f97\u6240\u538b\u8feb\u7684\u795e\u7ecf\u4e3a\u51fa\u53e3\u6839\uff0c\u800c\u975e\u5e38\u89c1\u7684\u8d70\u884c\u6839\uff0c\u8fd9\u4e00\u60c5\u51b5\u6781\u6613\u5e72\u6270\u533b\u5e08\u7684\u5224\u65ad\uff0c\u5bfc\u81f4\u5b9a\u4f4d\u51fa\u73b0\u504f\u5dee\u8fdb\u800c\u5f15\u53d1\u9996\u8bca\u65f6\u7684\u8bef\u8bca[17]<\/sup>\uff61<\/p>\n 3.2 \u8bca\u65ad\u6807\u51c6\u4e0e\u5f71\u50cf\u5b66\u7279\u5f81<\/p>\n FLLDH\u7684\u5206\u578b\u662f\u4f17\u591a\u5b66\u8005\u57fa\u4e8e\u89e3\u5256\u5b66\uff64\u5f71\u50cf\u5b66\u53ca\u4e34\u5e8a\u7279\u5f81\u957f\u671f\u79ef\u7d2f\u5f62\u6210\u7684\u5171\u8bc6\u4f53\u7cfb\uff0c\u5176\u6838\u5fc3\u76ee\u6807\u5728\u4e8e\u6307\u5bfc\u7cbe\u51c6\u8bca\u65ad\u4e0e\u4e2a\u4f53\u5316\u6cbb\u7597\uff61\u76ee\u524d\u4e3b\u8981\u5206\u578b\u53ef\u4ee5\u6982\u62ec\u4e3a\u52a8\u6001\u79fb\u4f4d\u5206\u578b\uff64\u89e3\u5256\u5b9a\u4f4d\u5206\u578b\uff64\u4e34\u5e8a-\u5f71\u50cf\u5206\u578b\u53ca\u795e\u7ecf\u6839\u7a7a\u95f4\u5173\u7cfb\u5206\u578b\uff0c\u89c1\u88682\uff61<\/p>\n \u88682 \u6781\u5916\u4fa7\u578b\u8170\u690e\u95f4\u76d8\u7a81\u51fa\u75c7\u5206\u578b<\/p>\n \u4e0d\u540c\u7c7b\u578b\u7684\u4e34\u5e8a\u8868\u73b0\u548c\u5f71\u50cf\u5b66\u7279\u5f81\u53ef\u4ee5\u51cf\u5c11\u4e34\u5e8a\u4e2d\u7684\u8bef\u8bca\u548c\u6f0f\u8bca\uff0c\u8fd8\u53ef\u4ee5\u9488\u5bf9\u690e\u95f4\u5b54\u5185\u578b\uff64\u690e\u95f4\u5b54\u5916\u578b\uff64\u6df7\u5408\u578b\u7b49\u9009\u62e9\u5408\u9002\u6cbb\u7597\u65b9\u6cd5\uff0c\u63d0\u9ad8\u7597\u6548\uff64\u6539\u5584\u9884\u540e\uff0c\u4e5f\u4fbf\u4e8e\u8bc4\u4f30\u6cbb\u7597\u6548\u679c\uff61<\/p>\n \u65e9\u671f\u8bca\u65adFLLDH\u5e38\u501f\u52a9\u5f71\u50cf\u5b66\u6280\u672f[18]<\/sup>\uff61CT\u68c0\u67e5\u80fd\u8fc5\u901f\u5224\u65ad\u690e\u95f4\u76d8\u7a81\u51fa\u7684\u4f4d\u7f6e\u4e0e\u7a81\u51fa\u7269\u5927\u5c0f\uff1bMRI\u53ef\u6e05\u6670\u5448\u73b0FLLDH\u75c5\u53d8\u690e\u95f4\u76d8\u5f62\u6001\u53ca\u5176\u4e0e\u795e\u7ecf\u6839\u7684\u6bd7\u90bb\u5173\u7cfb\uff0c\u4e3a\u8fdb\u4e00\u6b65\u63d0\u5347\u8bca\u65ad\u53ef\u9760\u6027\uff0c\u5efa\u8bae\u8f85\u4ee5\u51a0\u72b6\u4f4d\u6210\u50cf\u53ca\u589e\u5f3a\u626b\u63cf\u6280\u672f\uff0c\u901a\u8fc7\u4f18\u5316\u7ec4\u7ec7\u5bf9\u6bd4\u5ea6\u4e0e\u7a7a\u95f4\u5206\u8fa8\u7387\uff0c\u5b9e\u73b0\u5b9a\u4f4d\u53ca\u5b9a\u6027\u7684\u51c6\u786e\u6027\u663e\u8457\u63d0\u5347[19]<\/sup>\uff61<\/p>\n 3.3 \u6cbb\u7597<\/p>\n FLLDH\u7684\u6cbb\u7597\u9700\u9075\u5faa\u9636\u68af\u5316\u7b56\u7565\uff0c\u7efc\u5408\u8bc4\u4f30\u75c5\u60c5\u4e0e\u60a3\u8005\u4e2a\u4f53\u5dee\u5f02\uff61\u4fdd\u5b88\u6cbb\u7597\u5e38\u4e3a\u9996\u9009\uff0c\u901a\u8fc7\u5367\u5e8a\u4f11\u606f\u51cf\u8f7b\u8170\u690e\u538b\u529b\uff0c\u8054\u5408\u975e\u753e\u4f53\u6297\u708e\u836f\uff08\u5982\u5e03\u6d1b\u82ac\uff09\uff64\u795e\u7ecf\u8425\u517b\u836f\u7269\uff08\u7532\u94b4\u80fa\uff09\u53ca\u70ed\u6577\uff64\u7275\u5f15\uff64\u9488\u7078\u7b49\u7269\u7406\u7597\u6cd5\uff0c\u4ee5\u7f13\u89e3\u708e\u75c7\uff64\u6539\u5584\u795e\u7ecf\u529f\u80fd[23]<\/sup>\uff61<\/p>\n \u82e5\u4fdd\u5b88\u6cbb\u7597\u65e0\u6548\u6216\u5b58\u5728\u795e\u7ecf\u8fdb\u884c\u6027\u635f\u5bb3[24]<\/sup>\uff0c\u5219\u9700\u624b\u672f\u5e72\u9884\uff61\u5fae\u521b\u6280\u672f\u56e0\u5176\u521b\u4f24\u5c0f\uff64\u6062\u590d\u5feb\u7684\u7279\u70b9\u6210\u4e3a\u4e3b\u6d41\u9009\u62e9\uff1a\u7ecf\u76ae\u690e\u95f4\u5b54\u955c\u6280\u672f\uff08percutaneous endoscopic discectomy, PELD\uff09\u53ef\u7cbe\u51c6\u6458\u9664\u7a81\u51fa\u7269\uff0c\u7814\u7a76\u663e\u793a\u5176\u7597\u6548\u4f18\u4e8e\u4f20\u7edf\u5f00\u653e\u624b\u672f\u4e14\u672f\u540e\u75bc\u75db\u66f4\u8f7b\uff0cUBE\u901a\u8fc7\u690e\u65c1\u5165\u8def\u5b9e\u73b0\u6e05\u6670\u89c6\u91ce\u4e0b\u7684\u5b89\u5168\u51cf\u538b\uff0c\u4e34\u5e8a\u5e94\u7528\u4e2d\u5c55\u73b0\u51fa\u9ad8\u4f18\u826f\u7387\u4e0e\u4f4e\u5e76\u53d1\u75c7\u98ce\u9669[25]<\/sup>\uff0c\u4e3a\u8be5\u75c5\u75c7\u7684\u6cbb\u7597\u63d0\u4f9b\u4e86\u4e00\u79cd\u6709\u6548\u7684\u5fae\u521b\u89e3\u51b3\u65b9\u6848\uff1b\u5fae\u521b\u7ecf\u690e\u95f4\u5b54\u8170\u690e\u690e\u4f53\u95f4\u878d\u5408\u672f\uff08minimallyi nvasive transforaminal lumbar interbody fusion, MIS-TLIF\uff09\u5219\u9002\u7528\u4e8e\u5408\u5e76\u810a\u67f1\u4e0d\u7a33\u7684\u590d\u6742\u75c5\u4f8b\uff0c\u5176\u7597\u6548\u4e0e\u4f20\u7edf\u5f00\u653e\u624b\u672f\u76f8\u5f53\uff0c\u4f46\u5177\u6709\u51fa\u8840\u5c11\uff64\u4f4f\u9662\u65f6\u95f4\u77ed\u7b49\u4f18\u52bf[26]<\/sup>\uff61<\/p>\n \u5f20\u5148\u9e4f\u7b49[27]<\/sup>\u4e3a\u4e86\u8bc4\u4f30UBE\u6280\u672f\u6cbb\u7597FLLDH\u7684\u6548\u679c\uff61\u7814\u7a76\u9009\u53d625\u4f8b\u60a3\u8005\uff0c\u6839\u636e\u7a81\u51fa\u4f4d\u7f6e\u5206\u578b\u5e76\u786e\u5b9a\u95f4\u9699\u5206\u5e03\uff61\u624b\u672f\u7ecf\u690e\u65c1\u5165\u8def\uff0c\u51fa\u8840\u91cf\u5c11\uff0c\u65f6\u95f4\u9002\u4e2d\uff61\u672f\u540e\u60a3\u8005\u4e0b\u80a2\u548c\u8170\u90e8\u75bc\u75db\u53ca\u529f\u80fd\u969c\u788d\u660e\u663e\u6539\u5584\uff0c\u4f18\u826f\u7387\u8fbe96.0%\u4e14\u65e0\u5e76\u53d1\u75c7\uff61<\/p>\n Saela\u7b49[28]<\/sup>\u7684\u7814\u7a76\u8868\u660e\u624b\u672f\u662f\u6cbb\u7597\u8170\u690e\u9000\u884c\u6027\u75be\u75c5\u7684\u6709\u6548\u624b\u6bb5\uff0c\u662f\u4f20\u7edf\u5f00\u653e\u624b\u672f\u7684\u826f\u597d\u66ff\u4ee3\uff61\u5176\u9002\u5e94\u8bc1\u5e7f\u6cdb\uff0cMI-TLIF\u5177\u6709\u51fa\u8840\u5c11\uff64\u75bc\u75db\u8f7b\uff64\u4f4f\u9662\u77ed\u7b49\u4f18\u70b9\uff61\u4ee5\u690e\u95f4\u5b54\u955c\uff64UBE\u4e3a\u4ee3\u8868\u7684\u5fae\u521b\u6280\u672f\u901a\u8fc7\u7cbe\u51c6\u5316\u64cd\u4f5c\u4e0e\u6700\u5c0f\u5316\u7ec4\u7ec7\u635f\u4f24\uff0c\u5728\u6539\u5584\u75c7\u72b6\uff64\u52a0\u901f\u5eb7\u590d\u53ca\u51cf\u5c11\u5e76\u53d1\u75c7\u65b9\u9762\u5177\u6709\u663e\u8457\u4e34\u5e8a\u4ef7\u503c\uff61<\/p>\n \u9677\u9631\u56db\uff1a\u68d8\u7a81\u95f4\u9aa8\u5173\u8282\u75c5\uff08Baastrup’s\u75c5\uff09<\/p>\n 4.1\u6982\u8ff0<\/p>\n Baastrup’s\u75c5\uff0c\u57281933\u5e74\u7531\u4e39\u9ea6\u653e\u5c04\u79d1\u533b\u5e08Christian Baastrup\u9996\u6b21\u63cf\u8ff0\uff0c\u53c8\u79f0\u543b\u5408\u690e\u7efc\u5408\u5f81\uff64\u8170\u690e\u543b\u5408\u68d8\u75c5\uff64\u68d8\u7a81\u95f4\u9aa8\u5173\u8282\u75c5\u7b49[29]<\/sup>\uff61\u5176\u7279\u5f81\u4e3a\u8170\u690e\u68d8\u7a81\u76f8\u4e92\u9760\u8fd1\uff64\u649e\u51fb\uff0c\u81f4\u4f7f\u76f8\u5bf9\u7f18\u9aa8\u8d28\u589e\u751f\uff64\u786c\u5316\uff0c\u68d8\u7a81\u6775\u72b6\u589e\u7c97\uff0c\u89c1\u56fe9\uff0c\u76f8\u5bf9\u9762\u53d8\u5e73\u751a\u81f3\u5f62\u6210\u5047\u5173\u8282\uff0c\u60a3\u8005\u5e38\u4f34\u6709\u7a0b\u5ea6\u4e0d\u7b49\u7684\u8170\u80cc\u90e8\u75bc\u75db\u75c5\u53f2\uff0c\u53d7\u7d2f\u68d8\u7a81\u6709\u56fa\u5b9a\u538b\u75db[30]<\/sup>\uff61<\/p>\n \u56fe9\uff08\u53f3\uff09\u8170\u690e\u68d8\u7a81\u76f8\u4e92\u9760\u8fd1\uff64\u649e\u51fb\uff0c\u81f4\u4f7f\u76f8\u5bf9\u7f18\u9aa8\u8d28\u589e\u751f\uff64\u786c\u5316\uff0c\u68d8\u7a81\u6775\u72b6\u589e\u7c97<\/p>\n Baastrup’s\u75c5\u662f\u4e00\u79cd\u7f55\u89c1\u7684\u810a\u690e\u75be\u75c5\uff0c\u5e38\u56e0\u4e34\u5e8a\u533b\u5e08\u77e5\u8bc6\u548c\u7ecf\u9a8c\u7684\u4e0d\u8db3\u800c\u88ab\u8bef\u8bca\u548c\u9519\u8bef\u6cbb\u7597\uff61\u5f53\u60a3\u8005\u5408\u5e76\u6709\u8170\u690e\u95f4\u76d8\u7a81\u51fa\u548cBaastrup’s\u75c5\u65f6\uff0c\u533b\u5e08\u6613\u5c06Baastrup’s\u75c5\u8bef\u8bca\u4e3a\u76d8\u6e90\u6027\u8170\u75db\u800c\u8fdb\u884c\u690e\u95f4\u76d8\u7684\u624b\u672f\uff61\u56e0\u6b64\uff0c\u8fdb\u4e00\u6b65\u6df1\u5165\u4e86\u89e3\u5176\u53d1\u75c5\u673a\u5236\uff64\u5f71\u50cf\u5b66\u7279\u5f81\u4ee5\u53ca\u4e34\u5e8a\u8868\u73b0\uff0c\u5bf9\u4e8e\u63d0\u9ad8\u4e34\u5e8a\u533b\u5e08\u7684\u8bca\u65ad\u51c6\u786e\u6027\u548c\u6cbb\u7597\u6548\u679c\u5177\u6709\u81f3\u5173\u91cd\u8981\u7684\u610f\u4e49\uff61<\/p>\n 4.2 \u8bca\u65ad\u6807\u51c6\u4e0e\u5f71\u50cf\u5b66\u7279\u5f81<\/p>\n \u76ee\u524d\u5173\u4e8eBaastrup’s\u75c5\u7684\u5206\u578b\u5c1a\u65e0\u7edf\u4e00\u6807\u51c6\uff61\u4e00\u4e9b\u7814\u7a76\u6839\u636e\u5f71\u50cf\u5b66\u8868\u73b0\u6216\u75c5\u7406\u7279\u5f81\u8fdb\u884c\u4e86\u521d\u6b65\u5206\u7c7b\uff0cHu\u7b49[31]<\/sup>\u57fa\u4e8e\u5f71\u50cf\u5b66\u548c\u4e34\u5e8a\u75c7\u72b6\u7684\u8170\u690eBaastrup’s\u75c5\u63cf\u8ff0\u4e86\u4e00\u79cd\u65b0\u5206\u7c7b\u65b9\u6cd5\uff0c\u5e76\u68c0\u9a8c\u5176\u53ef\u9760\u6027\u548c\u53ef\u91cd\u590d\u6027\uff61\u5728116\u4f8b\u60a3\u8005\u8d44\u6599\u4e2d\uff0c\u6839\u636e\u5f71\u50cf\u5b66\u7279\u5f81\u5c06\u5176\u5206\u4e3a\u5355\u8282\u6bb5\uff08I\u578b\uff09\u548c\u591a\u8282\u6bb5\uff08\u2161\u578b\uff09\uff0c\u518d\u6839\u636e\u9000\u53d8\u7a0b\u5ea6\u7ec6\u5206\u4e9a\u578b\uff0c\u5e76\u7ed3\u5408\u4e34\u5e8a\u75c7\u72b6\u8fdb\u4e00\u6b65\u5206\u7c7b\uff61\u7ed3\u679c\u663e\u793a\uff0c\u65b0\u7684\u5206\u7c7b\u65b9\u6cd5\u5177\u6709\u826f\u597d\u7684\u53ef\u4fe1\u5ea6\u548c\u53ef\u91cd\u590d\u6027\uff0c\u53ef\u4e3a\u4e34\u5e8a\u6cbb\u7597\u63d0\u4f9b\u6307\u5bfc\uff61<\/p>\n \u8fdb\u4e00\u6b65\u7684\u7814\u7a76\u53ef\u80fd\u6709\u52a9\u4e8e\u660e\u786e\u8be5\u75be\u75c5\u7684\u5206\u578b\uff0c\u4ece\u800c\u4e3a\u66f4\u7cbe\u51c6\u7684\u8bca\u65ad\u548c\u6cbb\u7597\u63d0\u4f9b\u4f9d\u636e\uff61Baastrup’s\u75c5\u7684\u8bca\u65ad\u901a\u8fc7\u4e34\u5e8a\u68c0\u67e5\u548c\u5f71\u50cf\u5b66\u68c0\u67e5\u5f97\u5230\u9a8c\u8bc1[32]<\/sup>\uff61X\u7ebf\u7247\u6700\u5e38\u89c1\u7684\u8868\u73b0\u662f\u76f8\u90bb\u68d8\u7a81\u7684\u7d27\u5bc6\u63a5\u8fd1\u548c\u63a5\u89e6\uff0c\u5e76\u4e14\u5173\u8282\u9762\u51fa\u73b0\u786c\u5316\uff61\u4e0d\u4ec5\u5982\u6b64\uff0c\u5728\u75c5\u60c5\u66f4\u4e3a\u4e25\u91cd\u7684\u60c5\u51b5\u4e0b\uff0c\u8fd8\u4f1a\u51fa\u73b0\u5173\u8282\u9762\u7684\u6241\u5e73\u548c\u589e\u5927\uff0c\u751a\u81f3\u4e24\u4e2a\u53d7\u5f71\u54cd\u7684\u68d8\u7a81\u4e4b\u95f4\u4f1a\u878d\u5408\uff61<\/p>\n \u6b64\u5916\uff0c\u901a\u5e38\u5728\u75c5\u7406\u6c34\u5e73\u4e0a\uff0c\u8fd8\u80fd\u591f\u89c2\u5bdf\u5230\u810a\u67f1\u7684\u4e00\u822c\u9000\u884c\u6027\u6539\u53d8\uff0c\u4e14\u8fd9\u79cd\u6539\u53d8\u6700\u4e3a\u663e\u8457\uff61\u8be5\u6280\u672f\u6210\u672c\u8f83\u4f4e\u4e14\u5177\u6709\u5e7f\u6cdb\u7684\u53ef\u7528\u6027\uff0c\u540c\u65f6\u6240\u4ea7\u751f\u7684\u7535\u79bb\u8f90\u5c04\u5242\u91cf\u4e5f\u76f8\u5bf9\u8f83\u4f4e\uff61\u4f46\u5728\u80a5\u80d6\u60a3\u8005\u7684\u4e0b\u8170\u690e\u6c34\u5e73\uff0c\u6210\u50cf\u8d28\u91cf\u5f80\u5f80\u8f83\u5dee\uff61<\/p>\n CT\uff1a\u901a\u8fc7\u5bf9CT\u8f74\u4f4d\u56fe\u50cf\u8fdb\u884c\u77e2\u72b6\u4f4d\u548c\u51a0\u72b6\u4f4d\u91cd\u5efa\uff0c\u53ef\u4ee5\u6e05\u6670\u5730\u5448\u73b0\u51fa\u76f8\u90bb\u68d8\u7a81\u7684\u7d27\u5bc6\u63a5\u8fd1\u548c\u63a5\u89e6\u72b6\u6001[33]<\/sup>\uff0c\u540c\u65f6\u8fd8\u80fd\u89c2\u5bdf\u5230\u4f34\u968f\u51fa\u73b0\u7684\u786c\u5316\u73b0\u8c61\uff0c\u4ee5\u53ca\u5173\u8282\u9762\u7684\u53d8\u5e73\u548c\u6269\u5927\uff0c\u751a\u81f3\u4e24\u4e2a\u68d8\u7a81\u4e4b\u95f4\u5f62\u6210\u5173\u8282\u7684\u60c5\u51b5\uff1bMRI\uff1a\u5728\u5c11\u6570\u6709\u75c7\u72b6\u60a3\u8005\u4e2d\u53ef\u663e\u793a\u8170\u690e\u68d8\u95f4\u6ed1\u56ca\u708e\uff0c\u8868\u73b0\u4e3a\u76f8\u90bb\u68d8\u7a81\u95f4\u7684\u6db2\u6027\u4fe1\u53f7\uff0c\u8fd8\u53ef\u89c1\u5173\u8282\u9762\u6241\u5e73\uff64\u786c\u5316\uff64\u589e\u5927\uff64\u56ca\u6027\u75c5\u53d8\uff64\u9aa8\u6c34\u80bf\u7b49\uff0c\u4ee5\u53ca\u68d8\u95f4\u97e7\u5e26\u6c34\u80bf\u548c\u589e\u5f3a[34]<\/sup>\uff61<\/p>\n 4.3 \u6cbb\u7597<\/p>\n Baastrup’s\u75c5\u7684\u6cbb\u7597\u7b56\u7565\u9700\u6839\u636e\u75c5\u60c5\u4e25\u91cd\u7a0b\u5ea6\u53ca\u60a3\u8005\u4e2a\u4f53\u60c5\u51b5\u5206\u5c42\u9009\u62e9\uff61\u4fdd\u5b88\u6cbb\u7597\u4f5c\u4e3a\u521d\u59cb\u65b9\u6848\uff0c\u4e3b\u8981\u5305\u62ec\u975e\u753e\u4f53\u6297\u708e\u836f\uff64\u808c\u8089\u677e\u5f1b\u5242\u7b49\u836f\u7269\u7f13\u89e3\u75bc\u75db\u4e0e\u708e\u75c7\uff0c\u8054\u5408\u810a\u67f1\u5c48\u66f2\u953b\u70bc\u7b49\u7269\u7406\u6cbb\u7597\uff61<\/p>\n Singla\u7b49[35]<\/sup>\u62a5\u90531\u4f8b\u8001\u5e74\u60a3\u8005\u7ecf1\u5468\u836f\u7269\u5e72\u9884\u540e\u8f85\u4ee5\u5eb7\u590d\u8bad\u7ec3\uff0c6\u4e2a\u6708\u968f\u8bbf\u65f6\u75c7\u72b6\u663e\u8457\u6539\u5584\uff0c\u63d0\u793a\u65e9\u671f\u4fdd\u5b88\u6cbb\u7597\u5bf9\u90e8\u5206\u60a3\u8005\u6709\u6548\uff0c\u4f46\u56e0\u4e34\u5e8a\u8ba4\u77e5\u4e0d\u8db3\u5e38\u88ab\u8bef\u8bca\u6216\u5ef6\u8bef\uff61\u5bf9\u4e8e\u4fdd\u5b88\u6cbb\u7597\u53cd\u5e94\u4e0d\u4f73\u8005\uff0c\u4ecb\u5165\u6cbb\u7597\u53ef\u4f5c\u4e3a\u8fc7\u6e21\u9009\u62e9\uff61Filippiadis\u7b49[36]<\/sup>\u5bf955\u4f8b\u60a3\u8005\u5b9e\u65bd\u900f\u89c6\u5f15\u5bfc\u4e0b\u7ecf\u76ae\u6d78\u6da6\u6cbb\u7597\uff0c\u75bc\u75db\u8bc4\u5206\u660e\u663e\u964d\u4f4e\u4e14\u6d3b\u52a8\u80fd\u529b\u6539\u5584\uff1b\u68d8\u95f4\u97e7\u5e26\u5c40\u90e8\u9ebb\u9189\u8054\u5408\u7c7b\u56fa\u9187\u6ce8\u5c04\u53ef\u5feb\u901f\u7f13\u89e3\u75bc\u75db\uff0c\u82e5\u4ecb\u5165\u6cbb\u7597\u4ecd\u65e0\u6cd5\u6ee1\u8db3\u9700\u6c42\uff0c\u5219\u9700\u8003\u8651\u624b\u672f\u5e72\u9884\uff61<\/p>\n \u90e8\u5206\u68d8\u7a81\u5207\u9664\u672f\u56e0\u5e76\u53d1\u75c7\u98ce\u9669\u4f4e\uff64\u7597\u6548\u660e\u786e\u88ab\u5e7f\u6cdb\u91c7\u7528\uff0cCorr\u7b49[37]<\/sup>\uff64Kerroum\u7b49[38]<\/sup>\u62a5\u9053\u672f\u540e\u75bc\u75db\u663e\u8457\u7f13\u89e3\u4e14\u6062\u590d\u826f\u597d\uff61\u5fae\u521b\u6280\u672f\u5982\u5168\u5185\u955c\u624b\u672f\u901a\u8fc7\u5207\u9664\u9aa8\u8d58\uff64\u6062\u590d\u68d8\u7a81\u95f4\u9699\u6539\u5584\u75c7\u72b6\uff0cLin\u7b49[39]<\/sup>\u968f\u8bbf12\u4e2a\u6708\u663e\u793aVAS\u8bc4\u5206\u4e0b\u964d\u4e14CT\u8bc1\u5b9e\u89e3\u5256\u7ed3\u6784\u6539\u5584\uff61\u56e0\u6b64Baastrup’s\u75c5\u9700\u7efc\u5408\u8bc4\u4f30\u540e\u9009\u62e9\u9636\u68af\u6cbb\u7597\u65b9\u6848\uff0c\u4fdd\u5b88\u6cbb\u7597\u4e3a\u9996\u9009\uff0c\u96be\u6cbb\u6027\u75c5\u4f8b\u53ef\u9010\u6b65\u5347\u7ea7\u81f3\u4ecb\u5165\u6216\u624b\u672f\uff0c\u4ee5\u5e73\u8861\u7597\u6548\u4e0e\u521b\u4f24\u98ce\u9669\uff61<\/p>\n \u9677\u9631\u4e94\uff1a\u9acb\u5173\u8282\u75be\u75c5<\/p>\n 5.1 \u6982\u8ff0<\/p>\n \u9acb\u5173\u8282\u75be\u75c5\uff08\u5982\u80a1\u9aa8\u5934\u574f\u6b7b\uff64\u80a1\u9aa8\u9888\u9aa8\u6298\uff64\u9acb\u5173\u8282\u80bf\u7624\uff09\u53ef\u80fd\u5bfc\u81f4\u81c0\u90e8\u53ca\u5927\u817f\u540e\u4fa7\u75bc\u75db[40]<\/sup>\uff61\u5176\u75c7\u72b6\u533a\u57df\u4e0eLDH\u5b58\u5728\u91cd\u53e0\uff61\u4f46\u75bc\u75db\u6839\u6e90\u4e3a\u9acb\u5173\u8282\u539f\u53d1\u75c5\u53d8\uff08\u5982\u80a1\u9aa8\u5934\u574f\u6b7b\u8840\u4f9b\u969c\u788d\uff64\u80a1\u9aa8\u9888\u9aa8\u6298\u521b\u4f24\u523a\u6fc0[41]<\/sup>\u6216\u80bf\u7624\u4fb5\u88ad\u538b\u8feb[42]<\/sup>\uff61<\/p>\n \u5f53\u60a3\u8005\u5408\u5e76\u8170\u690e\u95f4\u76d8\u7a81\u51fa\u6216\u533b\u5e08\u4ec5\u4f9d\u8d56\u8170\u690eMRI\/CT\u68c0\u67e5\u672a\u7cfb\u7edf\u8bc4\u4f30\u9acb\u5173\u8282\u65f6\uff0c\u6613\u8bef\u5224\u4e3a\u5750\u9aa8\u795e\u7ecf\u75db\uff61\u5bfc\u81f4\u6cbb\u7597\u5ef6\u8bef\u53ca\u9519\u8bef\u5e72\u9884\uff08\u5982\u8170\u690e\u624b\u672f\uff09\uff0c\u52a0\u91cd\u60a3\u8005\u4e0d\u826f\u9884\u540e\uff61<\/p>\n 5.2 \u8bca\u65ad\u6807\u51c6\u4e0e\u5f71\u50cf\u5b66\u7279\u5f81<\/p>\n \u4f53\u683c\u68c0\u67e5\uff1aFABER\u8bd5\u9a8c\uff08Patrick\u8bd5\u9a8c\uff09\uff1a\u60a3\u8005\u4ef0\u5367\u4f4d\uff0c\u9acb\u5173\u8282\u5c48\u66f2\uff64\u5916\u5c55\uff64\u5916\u65cb\uff08\u4e0b\u80a2\u5448\u201c4\u201d\u5b57\u59ff\u52bf\uff09\uff0c\u5411\u4e0b\u6309\u538b\u819d\u5173\u8282\u8bf1\u53d1\u9acb\u90e8\u75bc\u75db\uff08\u9633\u6027\u63d0\u793a\u9acb\u5173\u8282\u75c5\u53d8\uff09\uff1bTrendelenburg\u5f81[43]<\/sup>\uff1a\u5355\u817f\u7ad9\u7acb\u65f6\uff0c\u5065\u4fa7\u9aa8\u76c6\u4e0b\u5782\uff0c\u9633\u6027\u63d0\u793a\u9acb\u5916\u5c55\u808c\u65e0\u529b\u6216\u9acb\u5173\u8282\u4e0d\u7a33\u5b9a\uff61\u76f4\u817f\u62ac\u9ad8\u8bd5\u9a8c\uff1aLDH\u60a3\u8005\u591a\u4e3a\u9633\u6027\uff0c\u62ac\u9ad8<60\u00b0\u8bf1\u53d1\u4e0b\u80a2\u75db\uff0c\u800c\u9acb\u5173\u8282\u75be\u75c5\u901a\u5e38\u9634\u6027\u5373\u75bc\u75db\u4e0e\u4f53\u4f4d\u65e0\u5173\uff61\u9acb\u5173\u8282\u51b2\u51fb\u8bd5\u9a8c\uff08\u5c48\u66f2\u5185\u65cb\u75db\u9633\u6027\u63d0\u793a\u9acb\u81fc\u649e\u51fb\u7efc\u5408\u5f81\uff09\uff61\u5f71\u50cf\u5b66\u65b9\u9762\uff1aX\u7ebf\u9aa8\u76c6\u6b63\/\u4fa7\u4f4d\uff1a\u8bc4\u4f30\u5173\u8282\u95f4\u9699\u72ed\u7a84\uff08\u9aa8\u6027\u5173\u8282\u708e\uff09\uff64\u80a1\u9aa8\u5934\u584c\u9677\uff08\u574f\u6b7b\uff09\uff64\u9aa8\u6298\u7ebf\uff08\u80a1\u9aa8\u9888\u9aa8\u6298\uff09\uff64\u9acb\u81fc\u8986\u76d6\u5f02\u5e38\uff08\u649e\u51fb\u7efc\u5408\u5f81\uff09\u7b49\uff61MRI\uff1a\u663e\u793a\u9acb\u81fc\u76c2\u5507\u6495\u88c2\uff64\u80a1\u9aa8\u5934\u9aa8\u9ad3\u6c34\u80bf\uff08\u574f\u6b7b\u65e9\u671f\uff09\u6216\u80bf\u7624\u4fe1\u53f7\uff0cT2WI\u8102\u80aa\u6291\u5236\u5e8f\u5217\u5bf9\u6ed1\u819c\u708e\u6216\u8f6f\u9aa8\u635f\u4f24\u654f\u611f\uff61CT\u4e09\u7ef4\u91cd\u5efa\uff1a\u7cbe\u786e\u663e\u793a\u9aa8\u6027\u7ed3\u6784\u5f02\u5e38\uff08\u5982\u9acb\u81fc\u8fb9\u7f18\u9aa8\u8d58\uff64\u80a1\u9aa8\u9888\u5e94\u529b\u6027\u9aa8\u6298\uff09\uff61\u653e\u5c04\u6027\u6838\u7d20\u9aa8\u626b\u63cf\uff08SPECT\/CT\uff09\uff1a\u7528\u4e8e\u9690\u533f\u6027\u9aa8\u6298\u6216\u65e9\u671f\u80bf\u7624\u7b5b\u67e5\uff0c\u8868\u73b0\u4e3a\u5c40\u90e8\u5f02\u5e38\u653e\u5c04\u6027\u6d53\u805a\uff61<\/p>\n \u88683 \u5404\u79cd\u9acb\u5173\u8282\u75be\u75c5\u7684\u5206\u578b\u4e0e\u6807\u5fd7\u6027\u7279\u5f81<\/p>\n 5.3 \u6cbb\u7597<\/p>\n \u5bf9\u4e8e\u80a1\u9aa8\u5934\u574f\u6b7b\u6cbb\u7597\u9700\u6839\u636e\u56fd\u9645\u9aa8\u5fae\u5faa\u73af\u7814\u7a76\u534f\u4f1a\uff08Association Research Circulation Osseous, ARCO\uff09\u5206\u671f\u9009\u62e9\uff61<\/p>\n \u65e9\u671f\u80a1\u9aa8\u5934\u5f62\u6001\u5b8c\u6574\uff64\u672a\u584c\u9677\uff08ARCO\u2161\u671f\uff09\u53ef\u91c7\u53d6\u4fdd\u5b88\u6cbb\u7597\uff0c\u5305\u62ec\u51cf\u8f7b\u8d1f\u91cd\uff64\u9ad8\u538b\u6c27\u6539\u5584\u5c40\u90e8\u8840\u4f9b\u53ca\u53cc\u81a6\u9178\u76d0\u5ef6\u7f13\u9aa8\u5438\u6536\uff0c\u4ea6\u53ef\u8054\u5408\u9ad3\u82af\u51cf\u538b\u672f\u4ee5\u964d\u4f4e\u9aa8\u5185\u538b\u5e76\u4fc3\u8fdb\u4fee\u590d\uff61\u82e5\u8fdb\u5c55\u81f3\u665a\u671f\uff08\u2162-\u2163\u671f\uff09\uff0c\u4eba\u5de5\u5168\u9acb\u5173\u8282\u7f6e\u6362\u672f\uff08total hip arthroplasty, THA\uff09\u662f\u6062\u590d\u529f\u80fd\u7684\u9996\u9009\u65b9\u6848\uff1b\u9acb\u81fc\u649e\u51fb\u7efc\u5408\u5f81[47-48]<\/sup>\u7684\u6cbb\u7597\u9700\u533a\u5206\u89e3\u5256\u5206\u578b\uff1a\u5bf9\u4e8e\u201c\u51f8\u8f6e\u578b\u201d\u6216\u201c\u94b3\u578b\u201d\u649e\u51fb\uff0c\u65e9\u671f\u53ef\u901a\u8fc7\u8c03\u6574\u8fd0\u52a8\u6a21\u5f0f\u53ca\u5c40\u90e8\u7cd6\u76ae\u8d28\u6fc0\u7d20\u6ce8\u5c04\u7f13\u89e3\u75c7\u72b6\uff0c\u4f46\u957f\u671f\u65e0\u6548\u6216\u4f34\u968f\u76c2\u5507\u6495\u88c2\u8005\u9700\u5173\u8282\u955c\u624b\u672f\u6e05\u9664\u9aa8\u8d58\uff64\u4fee\u590d\u76c2\u5507\u6216\u884c\u80a1\u9aa8\u5934\u9888\u6210\u5f62\u672f\uff0c\u4ee5\u89e3\u9664\u673a\u68b0\u649e\u51fb\u5e76\u9884\u9632\u7ee7\u53d1\u6027\u9aa8\u5173\u8282\u708e\uff1b\u80a1\u9aa8\u9888\u9aa8\u6298\u7684\u6cbb\u7597\u7b56\u7565\u4e0e\u9aa8\u6298\u7c7b\u578b\u5bc6\u5207\u76f8\u5173\uff0c\u7a33\u5b9a\u578b\uff08Garden\u2160-\u2161\u578b\uff09\u591a\u91c7\u7528\u5185\u56fa\u5b9a\u672f\uff08\u5982\u7a7a\u5fc3\u87ba\u9489\u6216\u52a8\u529b\u9acb\u87ba\u9489DHS\uff09\uff0c\u800c\u79fb\u4f4d\u578b\uff08Garden\u2162-\u2163\u578b\uff09\u56e0\u5185\u56fa\u5b9a\u540e\u80a1\u9aa8\u5934\u574f\u6b7b\u98ce\u9669\u9ad8\uff0c\u5e38\u63a8\u8350\u534a\u9acb\u6216\u5168\u9acb\u7f6e\u6362\u672f\uff08\u5c24\u5176\u8001\u5e74\u60a3\u8005\uff09\uff61<\/p>\n \u672f\u540e\u9700\u65e9\u671f\u5eb7\u590d\u8bad\u7ec3\u4ee5\u907f\u514d\u5173\u8282\u50f5\u786c\u53ca\u8840\u6813\u5f62\u6210\uff1b\u9acb\u5173\u8282\u9aa8\u6027\u5173\u8282\u708e[49]<\/sup>\u4ee5\u9636\u68af\u6cbb\u7597\u4e3a\u539f\u5219\uff0c\u8f7b\u578b\u60a3\u8005\u9996\u9009\u975e\u753e\u4f53\u6297\u708e\u836f\u7f13\u89e3\u75bc\u75db\uff0c\u6c28\u57fa\u8461\u8404\u7cd6\u4fdd\u62a4\u8f6f\u9aa8\uff0c\u8054\u5408\u9acb\u5468\u808c\u7fa4\u953b\u70bc\u589e\u5f3a\u5173\u8282\u7a33\u5b9a\u6027\uff0c\u5bcc\u8840\u5c0f\u677f\u8840\u6d46\u6ce8\u5c04\u53ef\u5ef6\u7f13\u75c5\u60c5\u8fdb\u5c55\uff0c\u7ec8\u672b\u671f\u60a3\u8005\u5219\u9700\u884cTHA\u4ee5\u5f7b\u5e95\u89e3\u9664\u75bc\u75db\u5e76\u6062\u590d\u6d3b\u52a8\u80fd\u529b\uff61<\/p>\n \u9274\u522b<\/p>\n LDH\u7684\u5178\u578b\u75c7\u72b6\u5e7f\u4e3a\u4eba\u77e5\uff0c\u4f46\u5176\u5e7f\u6cdb\u6027\u4e0e\u975e\u7279\u5f02\u6027\u4f7f\u5f97\u4e34\u5e8a\u4e2d\u6781\u6613\u4e0e\u591a\u79cd\u89e3\u5256\u7ed3\u6784\u5f02\u5e38\uff64\u795e\u7ecf\u5361\u538b\u53ca\u9000\u884c\u6027\u75c5\u53d8\u6df7\u6dc6\uff61\u9519\u8bef\u5730\u5c06\u201c\u9677\u9631\u75be\u75c5\u201d\u8bef\u5224\u4e3aLDH\uff0c\u53ef\u80fd\u5bfc\u81f4\u4fdd\u5b88\u6cbb\u7597\u65e0\u6548\uff64\u4e0d\u5fc5\u8981\u7684\u624b\u672f\u5e72\u9884\u6216\u672f\u540e\u75c7\u72b6\u6b8b\u7559\uff0c\u4e25\u91cd\u5f71\u54cd\u60a3\u8005\u9884\u540e\uff61\u56e0\u6b64\uff0c\u7cbe\u51c6\u8bc6\u522b\u5173\u952e\u5dee\u5f02\u70b9\u662f\u907f\u514d\u8bef\u8bca\u7684\u6838\u5fc3\uff0c\u9700\u57fa\u4e8e\u75c5\u53f2\u91c7\u96c6\uff64\u52a8\u6001\u67e5\u4f53\u53ca\u9488\u5bf9\u6027\u7684\u5f71\u50cf\u5b66\u5224\u8bfb\u6784\u5efa\u591a\u7ef4\u5ea6\u9274\u522b\u6846\u67b6\uff61<\/p>\n 6.1 Bertolotti’s\u7efc\u5408\u5f81 \u2460\u75c5\u53f2\u7279\u5f81 \u5e74\u8f7b\u60a3\u8005\uff0830\u5c81\u524d\u51fa\u73b0\u75c7\u72b6\uff09\uff0c\u6162\u6027\u8170\u75db\u4f34\u4e0b\u80a2\u653e\u5c04\u75db\uff0c\u4fdd\u5b88\u6cbb\u7597\uff08\u836f\u7269\uff64\u7406\u7597\uff09\u6548\u679c\u5dee\uff61\u75bc\u75db\u6027\u8d28\u4e3a\u673a\u68b0\u6027\uff08\u6d3b\u52a8\u540e\u52a0\u91cd\uff0c\u4f11\u606f\u65e0\u7f13\u89e3\uff09\uff61\u2461\u4f53\u683c\u68c0\u67e5 L5\u795e\u7ecf\u6839\u53d7\u538b\u4f53\u5f81\uff1a\u8e1d\u80cc\u5c48\u65e0\u529b\uff64\u8db3\u80cc\u5916\u4fa7\u611f\u89c9\u51cf\u9000\uff61\u8170\u9ab6\u90e8\u5047\u5173\u8282\u5c40\u90e8\u89e6\u8bca\u538b\u75db\u660e\u663e\uff61\u2462\u5f71\u50cf\u5b66\u7279\u5f81 X\u7ebf\/\u4e09\u7ef4CT\uff1a\u660e\u786eLSTV\u5206\u578b\uff08Castellvi\u5206\u578b\uff09\uff0c\u663e\u793a\u6a2a\u7a81\u80a5\u5927\uff64\u5047\u5173\u8282\u5f62\u6210\u6216\u9ab6\u9aa8\u878d\u5408\uff61MRI\u795e\u7ecf\u6210\u50cf\uff1aL5\u795e\u7ecf\u6839\u5728\u690e\u95f4\u5b54\u5916\u53e3\u53d7\u538b\u6216\u6c34\u80bf\uff61<\/p>\n 6.2 \u8fdc\u5916\u4fa7\u7efc\u5408\u5f81\/\u8fdc\u7aef\u7efc\u5408\u5f81 \u2460\u75c5\u53f2\u7279\u5f81 \u4e0b\u80a2\u653e\u5c04\u75db\u5267\u70c8\uff0c\u75bc\u75db\u6cbfL5\u795e\u7ecf\u6839\u5206\u5e03\uff08\u5c0f\u817f\u5916\u4fa7\uff64\u8db3\u80cc\uff09\uff61\u5e38\u89c1\u4e8e\u9000\u53d8\u6027\u8170\u690e\u4fa7\u51f8\uff08\u8001\u5e74\u4eba\uff09\u6216\u5ce1\u90e8\u88c2\u5408\u5e76\u6ed1\u8131\uff08\u4e2d\u9752\u5e74\uff09\uff61\u2461\u4f53\u683c\u68c0\u67e5 \u76f4\u817f\u62ac\u9ad8\u8bd5\u9a8c\u53ef\u80fd\u9634\u6027\uff08\u538b\u8feb\u90e8\u4f4d\u5728\u690e\u95f4\u5b54\u5916\uff09\uff61L5\u795e\u7ecf\u6839\u4f53\u5f81\uff1a\u8dbe\u80cc\u4f38\u808c\u529b\u4e0b\u964d\uff08\u2162-\u2163\u7ea7\uff09\uff0c\u8153\u9aa8\u957f\u77ed\u808c\u65e0\u529b\uff61\u2462\u5f71\u50cf\u5b66\u7279\u5f81 DTI\uff1a\u4e09\u7ef4\u663e\u793a\u795e\u7ecf\u6839\u8d70\u884c\uff0c\u660e\u786e\u5916\u4fa7\u51fa\u53e3\u533a\u72ed\u7a84\uff61\u4e09\u7ef4CT\uff1aL5 \u6a2a\u7a81\u4e0b\u7f18\u9aa8\u8d58\u6216\u9ab6\u9aa8\u7ffc\u9aa8\u8d28\u589e\u751f\uff61<\/p>\n 6.3 \u6781\u5916\u4fa7\u690e\u95f4\u76d8\u7a81\u51fa \u2460\u75c5\u53f2\u7279\u5f81 \u4e0b\u80a2\u6839\u6027\u75db\u663e\u8457\uff0c\u8170\u90e8\u75bc\u75db\u8f7b\u5fae\u6216\u65e0\u75db\uff61\u75bc\u75db\u8303\u56f4\u4e0e\u51fa\u53e3\u6839\u652f\u914d\u533a\u4e00\u81f4\uff08\u5982L4\u795e\u7ecf\u6839\u2192\u5927\u817f\u524d\u5916\u4fa7\uff64\u5c0f\u817f\u5185\u4fa7\uff09\uff61\u2461\u4f53\u683c\u68c0\u67e5 \u9acb\u5916\u5c55\u808c\u529b\u51cf\u5f31\uff08Trendelenburg\u5f81\u9633\u6027\uff09\uff61\u5bf9\u5e94\u795e\u7ecf\u6839\u652f\u914d\u533a\u611f\u89c9\u5f02\u5e38\uff08\u5982L3\u795e\u7ecf\u6839\u2192\u819d\u53cd\u5c04\u51cf\u5f31\uff09\uff61\u2462\u5f71\u50cf\u5b66\u7279\u5f81 MRI\u8f74\u4f4d\u8584\u5c42\u626b\u63cf\uff1a\u660e\u786e\u9ad3\u6838\u7a81\u51fa\u81f3\u690e\u5f13\u6839\u5916\u4fa7\u6216\u690e\u95f4\u5b54\u5916\uff61CT\u589e\u5f3a\uff1a\u663e\u793a\u7a81\u51fa\u7269\u4e0e\u795e\u7ecf\u6839\u63a5\u89e6\u53d8\u5f62\uff61<\/p>\n 6.4 \u68d8\u7a81\u95f4\u9aa8\u5173\u8282\u75c5\uff08Baastrup’s\u75c5\uff09 \u2460\u75c5\u53f2\u7279\u5f81 \u8170\u90e8\u540e\u4f38\u65f6\u75bc\u75db\u52a0\u91cd\uff08\u5982\u540e\u4ef0\u7ad9\u7acb\uff64\u642c\u91cd\u7269\uff09\uff61\u65e0\u4e0b\u80a2\u653e\u5c04\u6027\u75bc\u75db\u6216\u9ebb\u6728\uff08\u53ef\u4e0eLDH\u533a\u5206\uff09\uff61\u2461\u4f53\u683c\u68c0\u67e5 \u68d8\u7a81\u95f4\u9699\u56fa\u5b9a\u538b\u75db\uff0c\u810a\u67f1\u540e\u4f38\u8bf1\u53d1\u75bc\u75db\uff61\u76f4\u817f\u62ac\u9ad8\u8bd5\u9a8c\u9634\u6027\uff61\u2462\u5f71\u50cf\u5b66\u7279\u5f81 X\u7ebf\u4fa7\u4f4d\u7247\uff1a\u76f8\u90bb\u68d8\u7a81\u201c\u543b\u5408\u5f81\u201d\uff08\u63a5\u89e6\u7f18\u786c\u5316\uff64\u9aa8\u8d58\u5f62\u6210\uff0c\u4f3c\u63a5\u543b\uff09MRIT2WI\uff1a\u68d8\u7a81\u95f4\u6ed1\u56ca\u9ad8\u4fe1\u53f7\uff08\u6c34\u80bf\u6216\u708e\u75c7\uff09\uff61<\/p>\n 6.5 \u9acb\u5173\u8282\u76f8\u5173\u75be\u75c5 \u2460\u75c5\u53f2\u7279\u5f81 \u75bc\u75db\u4f4d\u4e8e\u8179\u80a1\u6c9f\u533a\u6216\u9acb\u5173\u8282\u5916\u4fa7\uff0c\u6d3b\u52a8\u540e\u52a0\u91cd\uff08\u884c\u8d70\uff64\u722c\u697c\u68af\uff09\uff61\u90e8\u5206\u60a3\u8005\u6709\u9acb\u90e8\u5916\u4f24\u53f2\u6216\u957f\u671f\u6fc0\u7d20\u4f7f\u7528\u53f2\uff08\u80a1\u9aa8\u5934\u574f\u6b7b\u98ce\u9669\uff09\uff61\u2461\u4f53\u683c\u68c0\u67e5 FABER\u8bd5\u9a8c\uff08\u9acb\u5173\u8282\u5c48\u66f2\u5916\u5c55\u5916\u65cb\uff09\uff1a\u8bf1\u53d1\u9acb\u90e8\u75bc\u75db\uff08\u9633\u6027\u63d0\u793a\u9acb\u75c5\u53d8\uff09\uff614\u5b57\u8bd5\u9a8c\uff1a\u9acb\u90e8\u75bc\u75db\u6216\u6d3b\u52a8\u53d7\u9650\uff61\u9acb\u5173\u8282\u6d3b\u52a8\u5ea6\u964d\u4f4e\uff08\u5185\u65cb\uff64\u5916\u5c55\u53d7\u9650\uff09\uff61\u2462\u5f71\u50cf\u5b66\u7279\u5f81 X\u7ebf\u9aa8\u76c6\u6b63\u4f4d\uff1a\u80a1\u9aa8\u5934\u584c\u9677 \uff08\u574f\u6b7b\uff09\uff64\u9acb\u81fc\u8986\u76d6\u4e0d\u826f\uff08\u649e\u51fb\uff09\uff61MRI\u9acb\u5173\u8282\uff1a\u65e9\u671f\u574f\u6b7b\u8868\u73b0\u4e3a\u201c\u53cc\u7ebf\u5f81\u201d\uff08T1WI\u4f4e\u4fe1\u53f7\uff0cT2WI\u9ad8\u4fe1\u53f7\uff09\uff61<\/p>\n \u8ba8\u8bba\u4e0e\u5c55\u671b<\/p>\n \u672c\u6587\u4ee5LDH\u4e3a\u5207\u5165\u70b9\uff0c\u63ed\u793a\u4e00\u4e2a\u503c\u5f97\u8b66\u60d5\u7684\u4e34\u5e8a\u6096\u8bba\uff1a\u867d\u7136\u5fae\u521b\u6280\u672f\u4e0e\u667a\u80fd\u5f71\u50cf\u5bfc\u822a\u5df2\u5c06\u73b0\u4ee3\u810a\u67f1\u5916\u79d1\u63a8\u5165\u7cbe\u51c6\u8bca\u7597\u65f6\u4ee3\uff0c\u4f46LDH\u7684\u8bef\u8bca\u6f0f\u8bca\u7387\u5e76\u672a\u5982\u9884\u671f\u6d88\u9000\uff0c\u53cd\u800c\u5728\u5f71\u50cf\u4f9d\u8d56\u52a0\u5267\uff64\u89e3\u5256\u601d\u7ef4\u6de1\u5316\u7684\u53cc\u91cd\u4f5c\u7528\u4e0b\uff0c\u5f62\u6210\u4e86\u66f4\u4e3a\u9690\u853d\u7684\u8ba4\u77e5\u9677\u9631\uff61<\/p>\n \u672a\u6765\u7a81\u7834\u65b9\u5411\u5e94\u805a\u7126\u4e8e\u6784\u5efa\u201c\u52a8\u6001\u9274\u522b\u8bca\u65ad\u6846\u67b6\u201d\uff1a\u9488\u5bf9\u7279\u6b8a\u89e3\u5256\u53d8\u5f02\uff08\u5982\u8170\u9ab6\u79fb\u884c\u690e\uff09\u6216\u975e\u5178\u578b\u75bc\u75db\u533a\u57df\uff0c\u53ef\u8bbe\u8ba1\u201c\u9636\u68af\u5f0f\u201d\u8bc4\u4f30\u65b9\u6848\u2014\u2014\u4ece\u57fa\u7840\u67e5\u4f53\u5230\u9488\u5bf9\u6027\u5f71\u50cf\u5b66\u91cd\u5efa\uff08\u5982\u51a0\u72b6\u4f4d MRI\u8584\u5c42\u626b\u63cf\uff09\uff0c\u4ece\u795e\u7ecf\u7535\u751f\u7406\u68c0\u6d4b\u5230\u8bca\u65ad\u6027\u5c01\u95ed\uff0c\u9010\u5c42\u5265\u79bb\u5e72\u6270\u56e0\u7d20\uff61\u552f\u6709\u5c06\u89e3\u5256\u8ba4\u77e5\u6df1\u5ea6\u878d\u5165\u4e34\u5e8a\u601d\u7ef4\uff0c\u8ba9\u6280\u672f\u771f\u6b63\u670d\u52a1\u4e8e\u9274\u522b\u8bca\u65ad\u800c\u975e\u66ff\u4ee3\u601d\u8003\uff0c\u624d\u80fd\u5316\u201c\u9677\u9631\u201d\u4e3a\u201c\u9636\u68af\u201d\uff0c\u63a8\u52a8LDH\u8bca\u7597\u4ece\u201c\u5f62\u6001\u5b66\u4e3b\u5bfc\u201d\u8fc8\u5411\u201c\u529f\u80fd-\u7ed3\u6784\u6574\u5408\u201d\u7684\u65b0\u9ad8\u5ea6\uff61<\/p>\n \u53c2\u8003\u6587\u732e<\/p>\n \u2191\u5411\u4e0a\u6ed1\u52a8\u67e5\u770b\u66f4\u591a\u2191<\/p>\n \u58f0\u660e\uff1a\u6b64\u6587\u5185\u5bb9\u53ca\u56fe\u7247\u7531\u4f9b\u7a3f\u5355\u4f4d\u63d0\u4f9b\uff0c\u4ec5\u4f9b\u5b66\u4e60\u4ea4\u6d41\uff0c\u4e0d\u4ee3\u8868\u9aa8\u79d1\u5728\u7ebf\u89c2\u70b9\u3002 #artContent h1#artContent p img#artContent table<\/p>\n","protected":false},"excerpt":{"rendered":" \u6765\u6e90\uff1a\u300a\u9888\u8170\u75db\u6742\u5fd7\u300b \u901a\u4fe1\u4f5c\u8005\uff1a\u9655\u897f\u7701\u4eba\u6c11\u533b\u9662\u9aa8\u79d1 \u9773\u5360\u594e \u8170\u690e\u95f4\u76d8\u7a81\u51fa\u75c7\uff08lu … \u7ee7\u7eed\u9605\u8bfb