腰椎牵引结合射频热凝术治疗椎间盘源性腰痛的初步疗效观察
发布时间：2018-10-25 19:01
【摘要】：目的：近年来椎间盘源性腰痛越来越被临床重视,它是所有不以神经组织受压为主要表现的腰椎间盘退行性疾病,本病多起病缓慢,并且缓解与复发迁延不断,是极为棘手的疾病之一。椎间盘源性下腰痛目前主要有保守治疗、微创治疗和开放手术三种方法。由于开放手术治疗的有创性、风险性、治疗费用昂贵,大部分患者无法接受,所以保守治疗和微创治疗则成为了大多数患者的选择。本文通过探讨腰椎牵引结合射频热凝术治疗椎间盘源性腰痛的初步疗效及其作用机制,从而为治疗椎间盘源性腰痛提供安全可行的康复方案。方法：将中国人民解放军第175医院住院采集的45例患者,按随机数字表法分为治疗组23例、对照组22例。治疗组(A组)采用射频热凝术治疗后第2天结合腰椎牵引治疗,对照组(B组)只采用射频靶点热凝术治疗,对患者的症状、体征及疼痛程度等情况进行观察记录,所有患者均进行有效随访,随访时间2-12个月,平均10个月,利用临床观察量表,在治疗前、治疗后末次随访时采用视觉模拟评分(VAS)、下腰痛评价量表(JOA)、腰椎功能障碍评分(Roland-Morris)测定及运用改良Macnab标准进行临床疗效评定,比较两组在治疗椎间盘源性腰痛的综合评分及疗效评价。结果：统计分析显示,A组VAS评分下降5.78±0.58,B组评分下降4.34士0.56,A组优于B组；A组JOA评分提高13.07士1.90,B组提高6.82±1.90,.治疗后分数均较治疗前提高,A组优于B组,且A组评分较B组提高明显;Roland-Morris分数治疗有所下降,A组Roland-Morris评分下降9.56±1.73,B组下降4.80±1.72, A组优于B组,A组评分较B组减少明显；改良MacNab临床疗效标准评定中,A组总有效率95.7%；B组总有效率为90.9%；两组差异具有统计学意义(P0.05),A组优于B组。结论：腰椎牵引结合射频热凝术与单纯射频热凝术治疗椎间盘源性腰痛两种方法都有效,牵引的配合应用可以更好地减少射频热凝术的术后并发症。两者结合具有疗效确切、安全、操作简单、费用较低、便于推广等优点,是治疗椎间盘源性下腰痛较为理想的方法之一,临床值得推广运用。
[Abstract]:Objective: in recent years, discogenic low back pain has been paid more and more attention in clinic. It is a degenerative disease of lumbar intervertebral disc which is not mainly characterized by the compression of nerve tissue. Is one of the most intractable diseases. At present, there are three main methods of low back pain: conservative treatment, minimally invasive treatment and open surgery. Due to the invasive, risky and expensive treatment of open surgery, most patients can not accept it, so conservative treatment and minimally invasive treatment have become the choice of most patients. This paper discusses the primary curative effect and mechanism of lumbar traction combined with radiofrequency thermocoagulation in the treatment of discogenic low back pain, so as to provide a safe and feasible rehabilitation scheme for the treatment of discogenic low back pain. Methods: a total of 45 patients were randomly divided into treatment group (n = 23) and control group (n = 22). The treatment group (group A) was treated with radiofrequency thermocoagulation combined with lumbar traction on the second day after radiofrequency thermocoagulation, while the control group (group B) was treated with radiofrequency thermocoagulation only. The symptoms, signs and pain degree of the patients were observed and recorded. All the patients were followed up effectively, the follow-up time was 2-12 months (mean 10 months). Using the clinical observation scale, the visual analogue scale (VAS),) was used to evaluate low back pain (JOA),) before and after the last follow-up. Lumbar dysfunction score (Roland-Morris) and modified Macnab criteria were used to evaluate the clinical efficacy. The comprehensive score and evaluation of curative effect were compared between the two groups in the treatment of discogenic low back pain. Results: statistical analysis showed that the VAS score of group A decreased by 5.78 卤0.58 渭 g / L, the score of group A decreased by 4.34 卤0.56A was better than that of group B, and the JOA score of group A was increased by 13.07 卤1.90 and 6.82 卤1.90m respectively. The scores of group A were better than those of group B, and the scores of group A were significantly higher than those of group B. The Roland-Morris score decreased, the Roland-Morris score of group A decreased 9.56 卤1.73%, the score of group B decreased 4.80 卤1.72, the score of group A was better than that of group B, and the score of group A was significantly lower than that of group B. The total effective rate of group A was 90.9 in group A and the total effective rate in group B was 90.9.The difference between the two groups was statistically significant (P0.05), A group was better than B group. Conclusion: lumbar traction combined with radiofrequency thermocoagulation and radiofrequency thermocoagulation are effective in the treatment of discogenic low back pain. The combined application of traction can better reduce the postoperative complications of radiofrequency thermocoagulation. The combination of the two has the advantages of exact curative effect, safety, simple operation, low cost and easy to be popularized. It is one of the more ideal methods for the treatment of low back pain caused by intervertebral disc, and it is worth popularizing in clinic.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
本文编号：2294551
[Abstract]:Objective: in recent years, discogenic low back pain has been paid more and more attention in clinic. It is a degenerative disease of lumbar intervertebral disc which is not mainly characterized by the compression of nerve tissue. Is one of the most intractable diseases. At present, there are three main methods of low back pain: conservative treatment, minimally invasive treatment and open surgery. Due to the invasive, risky and expensive treatment of open surgery, most patients can not accept it, so conservative treatment and minimally invasive treatment have become the choice of most patients. This paper discusses the primary curative effect and mechanism of lumbar traction combined with radiofrequency thermocoagulation in the treatment of discogenic low back pain, so as to provide a safe and feasible rehabilitation scheme for the treatment of discogenic low back pain. Methods: a total of 45 patients were randomly divided into treatment group (n = 23) and control group (n = 22). The treatment group (group A) was treated with radiofrequency thermocoagulation combined with lumbar traction on the second day after radiofrequency thermocoagulation, while the control group (group B) was treated with radiofrequency thermocoagulation only. The symptoms, signs and pain degree of the patients were observed and recorded. All the patients were followed up effectively, the follow-up time was 2-12 months (mean 10 months). Using the clinical observation scale, the visual analogue scale (VAS),) was used to evaluate low back pain (JOA),) before and after the last follow-up. Lumbar dysfunction score (Roland-Morris) and modified Macnab criteria were used to evaluate the clinical efficacy. The comprehensive score and evaluation of curative effect were compared between the two groups in the treatment of discogenic low back pain. Results: statistical analysis showed that the VAS score of group A decreased by 5.78 卤0.58 渭 g / L, the score of group A decreased by 4.34 卤0.56A was better than that of group B, and the JOA score of group A was increased by 13.07 卤1.90 and 6.82 卤1.90m respectively. The scores of group A were better than those of group B, and the scores of group A were significantly higher than those of group B. The Roland-Morris score decreased, the Roland-Morris score of group A decreased 9.56 卤1.73%, the score of group B decreased 4.80 卤1.72, the score of group A was better than that of group B, and the score of group A was significantly lower than that of group B. The total effective rate of group A was 90.9 in group A and the total effective rate in group B was 90.9.The difference between the two groups was statistically significant (P0.05), A group was better than B group. Conclusion: lumbar traction combined with radiofrequency thermocoagulation and radiofrequency thermocoagulation are effective in the treatment of discogenic low back pain. The combined application of traction can better reduce the postoperative complications of radiofrequency thermocoagulation. The combination of the two has the advantages of exact curative effect, safety, simple operation, low cost and easy to be popularized. It is one of the more ideal methods for the treatment of low back pain caused by intervertebral disc, and it is worth popularizing in clinic.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
【参考文献】
相关期刊论文 前3条
1 佟德民;刑士新;任锡禄;马晓红;;腰椎牵引治疗椎间盘源性腰痛的初步疗效观察[J];光明中医;2010年05期
2 齐强;党耕町;;激光在骨科领域中的应用[J];中国激光医学杂志;1992年01期
3 胡永胜;张玉坤;黄卫民;沙吾提江;高小亮;周纲;;不同浓度臭氧治疗椎间盘源性腰痛的疗效评价[J];中国疼痛医学杂志;2011年11期
，本文编号：2294551
本文链接：https://www.wllwen.com/yixuelunwen/waikelunwen/2294551.html
最近更新
教材专著
