靶点射频热凝消融联合臭氧治疗腰椎间盘突出症的疗效分析
发布时间：2018-08-14 09:53
【摘要】：目的C臂引导下对比研究经皮靶点射频热凝消融联合臭氧注射与单纯射频热凝治疗腰椎间盘突出症的短期内疼痛缓解情况和功能改善情况。分析探讨经皮靶点射频热凝联合臭氧注射治疗腰椎间盘突出症(Lumbar disc herniation,LDH)的短期临床疗效。方法纳入自2015年10月至2016年10月期间符合条件的LDH住院患者40名,随机分为A、B两组,每组20例,A组采用靶点射频热凝联合臭氧注射治疗,B组采用单纯靶点射频热凝术治疗。其中:A组男性14例,女性6例,平均年龄(39.19±6.87)岁,体质指数(23.28±1.88)Kg/m2,平均病史(3.94±1.97)月,腰椎间盘突出症发病节段均为单一节段,其中L3/4 5例,L4/5 12例,L5/S1 3例。B组男性12例,女性8例,平均年龄(38.92±7.13)岁,体质指数(23.36±1.90)Kg/m2,平均病程(3.68±1.82)月,腰椎间盘突出症发病节段L3/4 5例,L4/5 11例,L5/S1 4例。两组患者一般资料比较具有可比性,差异无统计学意义(P0.05)。两组患者均进行术前检查并采用数值疼痛强度评定量表评分(Numerical Rating Scale,NRS)、Oswestry功能障碍指数问卷表评分(Oswestry Disability Index,ODI)及直腿抬高角度(angle of straight leg raising,SLR)进行评定。在术后即刻、术后3天、术后1周、术后1个月应用NRS评分、ODI评分、直腿抬高试验及改良Macnab进行疗效评价(观察优良率)进行术后评定。所有病例均由1名骨科医师操作完成。应用SPSS 16.0统计软件对所得数据进行统计学分析。结果所有纳入病例均顺利完成随访,有效随访率100%。两组患者均未出现椎间盘炎、终板炎等并发症。两组患者术前NRS评分(8.40±0.94vs8.40±0.82)、ODI评分(48.0±1.21vs48.2±1.01)、SLR(37.5±9.25vs35.0±9.73)比较,差异无统计学意义(P0.05)。与术前比较,A、B两组术后NRS评分、ODI评分下降,SLR均升高(P0.05)。A、B两组间比较,术后A组患者NRS评分、ODI评分均低于B组,差异有显著统计学意义(P0.05);A组患者术后SLR显著高于B组,差异有显著统计学意义(P0.05)。术后改良Macnab疗效评定:术后即刻、术后3天两组间差异不具有统计学意义(P0.05),术后1周,术后1个月A组优良率显著高于B组,两组间差异具有统计学意义(P0.05)。结论在准确把握适应症与禁忌症的前提下,靶点射频热凝联合臭氧注射治疗腰椎间盘突出症比单纯使用靶点射频热凝消融治疗腰椎间盘突出症效果好。联合治疗术后恢复快,安全可靠,短期内的疼痛缓解和功能改善情况较好,短期效果理想。
[Abstract]:Objective to study the short-term pain relief and functional improvement of percutaneous radiofrequency thermocoagulation ablation combined with ozone injection and radiofrequency thermocoagulation alone in the treatment of lumbar disc herniation under C-arm guidance. Objective: to evaluate the short-term clinical effect of percutaneous radiofrequency thermocoagulation combined with ozone injection in the treatment of lumbar disc herniation. Methods from October 2015 to October 2016, 40 inpatients with LDH were randomly divided into two groups: group A (n = 20) and group B (n = 20) were treated by radiofrequency coagulation (RFA) combined with ozone injection. There were 14 males and 6 females in group A with an average age of (39.19 卤6.87) years, body mass index (BMI) of (23.28 卤1.88) kg / m2 and mean history of (3.94 卤1.97) months. The mean age was (38.92 卤7.13) years, body mass index (BMI) was (23.36 卤1.90) kg / m2, mean course of disease was (3.68 卤1.82) months. Two groups of patients with comparable general data, the difference was not statistically significant (P0.05). The patients in both groups were examined before operation and evaluated by (Numerical Rating scale (Numerical Rating scale) and (Oswestry Disability Index (Oswestry Index scale) and (angle of straight leg raising method (straight leg elevation Angle). Immediately after operation, 3 days after operation, 1 week after operation and 1 month after operation, NRS score and leg elevation test and modified Macnab were used to evaluate the curative effect (observe the excellent and good rate). All cases were performed by an orthopedic surgeon. SPSS 16.0 statistical software was used to analyze the data. Results all cases were followed up successfully, and the effective follow-up rate was 100%. There were no complications such as intervertebral disc inflammation and endplate inflammation in both groups. The preoperative NRS score of the two groups was (8.40 卤0.94vs8.40 卤0.82) and (48.0 卤1.21vs48.2 卤1.01). There was no significant difference between the two groups (P 0.05). Compared with those before operation, the NRS scores in group A were significantly lower than those in group B (P 0.05). The scores of SLR in group A were significantly higher than those in group B (P0.05), and the scores of SLR in group A were significantly higher than those in group B (P 0.05), and the scores of SLR in group A were significantly lower than those in group B (P 0.05), and the scores of SLR in group A were significantly higher than those in group B (P 0.05). The difference was statistically significant (P0.05). There was no significant difference between the two groups immediately after operation and 3 days after operation (P0.05). The excellent and good rate of group A was significantly higher than that of group B at 1 week and 1 month after operation (P0.05). Conclusion on the premise of accurate indication and contraindication, the therapeutic effect of radiofrequency coagulation combined with ozone injection on lumbar disc herniation is better than that of radiofrequency ablation alone in the treatment of lumbar disc herniation. The combined therapy has the advantages of rapid recovery, safety and reliability, good short-term pain relief and functional improvement, and satisfactory short-term effect.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R681.53
本文编号：2182488
[Abstract]:Objective to study the short-term pain relief and functional improvement of percutaneous radiofrequency thermocoagulation ablation combined with ozone injection and radiofrequency thermocoagulation alone in the treatment of lumbar disc herniation under C-arm guidance. Objective: to evaluate the short-term clinical effect of percutaneous radiofrequency thermocoagulation combined with ozone injection in the treatment of lumbar disc herniation. Methods from October 2015 to October 2016, 40 inpatients with LDH were randomly divided into two groups: group A (n = 20) and group B (n = 20) were treated by radiofrequency coagulation (RFA) combined with ozone injection. There were 14 males and 6 females in group A with an average age of (39.19 卤6.87) years, body mass index (BMI) of (23.28 卤1.88) kg / m2 and mean history of (3.94 卤1.97) months. The mean age was (38.92 卤7.13) years, body mass index (BMI) was (23.36 卤1.90) kg / m2, mean course of disease was (3.68 卤1.82) months. Two groups of patients with comparable general data, the difference was not statistically significant (P0.05). The patients in both groups were examined before operation and evaluated by (Numerical Rating scale (Numerical Rating scale) and (Oswestry Disability Index (Oswestry Index scale) and (angle of straight leg raising method (straight leg elevation Angle). Immediately after operation, 3 days after operation, 1 week after operation and 1 month after operation, NRS score and leg elevation test and modified Macnab were used to evaluate the curative effect (observe the excellent and good rate). All cases were performed by an orthopedic surgeon. SPSS 16.0 statistical software was used to analyze the data. Results all cases were followed up successfully, and the effective follow-up rate was 100%. There were no complications such as intervertebral disc inflammation and endplate inflammation in both groups. The preoperative NRS score of the two groups was (8.40 卤0.94vs8.40 卤0.82) and (48.0 卤1.21vs48.2 卤1.01). There was no significant difference between the two groups (P 0.05). Compared with those before operation, the NRS scores in group A were significantly lower than those in group B (P 0.05). The scores of SLR in group A were significantly higher than those in group B (P0.05), and the scores of SLR in group A were significantly higher than those in group B (P 0.05), and the scores of SLR in group A were significantly lower than those in group B (P 0.05), and the scores of SLR in group A were significantly higher than those in group B (P 0.05). The difference was statistically significant (P0.05). There was no significant difference between the two groups immediately after operation and 3 days after operation (P0.05). The excellent and good rate of group A was significantly higher than that of group B at 1 week and 1 month after operation (P0.05). Conclusion on the premise of accurate indication and contraindication, the therapeutic effect of radiofrequency coagulation combined with ozone injection on lumbar disc herniation is better than that of radiofrequency ablation alone in the treatment of lumbar disc herniation. The combined therapy has the advantages of rapid recovery, safety and reliability, good short-term pain relief and functional improvement, and satisfactory short-term effect.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R681.53
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