超声引导下水针刀治疗腰椎间盘突出症症的临床研究
发布时间：2018-11-10 07:04
【摘要】：目的:本研究通过评估患者在治疗前后的临床症状和体征方面和日常生活工作质量的变化,分析在超声引导下水针刀治疗腰椎间盘突出症的安全性和临床疗效。以期找到一种安全、经济及有效的治疗方法,可以减轻患者的临床症状,从而提高患者的生活质量。在临床上加以推广使用,同时为临床上运用针刀治疗腰椎间盘突出症提供了一种新的思维。方法:选取2015年12月至2016年12月期间广东省中医院确诊治疗的腰椎间盘突出症患者60例,依据随机分配原则分为超声引导组(U)和经验穿刺组(E),每组30例,经验穿刺组的患者凭医师经验下水针刀治疗,超声引导组的患者给予在超声引导下水针刀治疗,对所有患者治疗前、治疗后1周、1个月、3个月内应用视觉模拟评分法(Visual Analogue Scale/Score,VAS)进行疼痛评估 Oswestry 功能指数(oswestry disability index,ODI)及采用日本骨科医师协会神经功能(Japanese Orthopaedic Association,JOA)进行评定,观察不良反应发生情况,统计分析所有患者治疗前后VAS评分、ODI值和治疗效果。结果:在两组患者中,患者治疗前的年龄,性别,病程差别均无统计学意义。两组患者治疗前后的观察指标均有明显改善,与治疗前比较,差异均有统计学意义(P0.05);治疗前两组患者VAS评分,ODI值及JOA评分差异无统计学意义(P0.05),但是超声引导组患者各时点VAS评分及ODI值明显低于经验组,且超声引导组各个时点的JOA评分均高于经验穿刺组,差异有统计学意义(P0.05)。在所有患者随访过程中未出现严重并发症。结论:应用超声引导下水针刀治疗腰椎间盘突出症的准确度高、不良反应低,并且有助于提高对患者的疗效。超声引导下水针刀治疗是一种安全,可靠及可视化的治疗方法,值得临床推广应用。
[Abstract]:Objective: to evaluate the changes of clinical symptoms and signs and the quality of daily life of patients before and after treatment, and to analyze the safety and clinical efficacy of water needle knife under ultrasound guidance in the treatment of lumbar disc herniation. In order to find a safe, economical and effective treatment method, can reduce the clinical symptoms of patients and improve the quality of life of patients. It provides a new way of thinking for the treatment of lumbar disc herniation. Methods: from December 2015 to December 2016, 60 patients with lumbar disc herniation were selected from Guangdong Provincial Hospital of traditional Chinese Medicine. According to the principle of random distribution, they were divided into two groups: ultrasound guided group (U) and experiential puncture group (E),). The patients in the experience puncture group were treated with needle knife through the doctor's experience, and the patients in the ultrasonic guidance group were treated with water needle knife under the guidance of ultrasound. All the patients were treated before, 1 week and 1 month after treatment. Oswestry function index (oswestry disability index,ODI) and neurologic function (Japanese Orthopaedic Association,JOA (Japanese Orthopaedic Association,JOA) were evaluated by visual analogue score (Visual Analogue Scale/Score,VAS) and neurologic function index (Japanese Orthopaedic Association,JOA) respectively. Adverse reactions were observed and VAS score, ODI value and therapeutic effect were statistically analyzed before and after treatment. Results: there was no significant difference in age, sex and course of disease between the two groups. The two groups of patients before and after treatment were significantly improved before and after treatment, compared with before treatment, the difference was statistically significant (P0.05); There was no significant difference in VAS score, ODI score and JOA score between the two groups before treatment (P0.05), but the VAS score and ODI value in the ultrasound guided group were significantly lower than those in the experience group. The JOA score of ultrasound guided group was higher than that of experience puncture group at each time point, the difference was statistically significant (P0.05). No serious complications occurred during follow-up in all patients. Conclusion: the treatment of lumbar intervertebral disc herniation with ultrasonic guided water needle knife has high accuracy and low adverse reaction, and it is helpful to improve the curative effect on the patients with lumbar intervertebral disc herniation. Ultrasonic guided water needle knife therapy is a safe, reliable and visual treatment method, which is worth popularizing in clinic.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9
，
本文编号：2321730
[Abstract]:Objective: to evaluate the changes of clinical symptoms and signs and the quality of daily life of patients before and after treatment, and to analyze the safety and clinical efficacy of water needle knife under ultrasound guidance in the treatment of lumbar disc herniation. In order to find a safe, economical and effective treatment method, can reduce the clinical symptoms of patients and improve the quality of life of patients. It provides a new way of thinking for the treatment of lumbar disc herniation. Methods: from December 2015 to December 2016, 60 patients with lumbar disc herniation were selected from Guangdong Provincial Hospital of traditional Chinese Medicine. According to the principle of random distribution, they were divided into two groups: ultrasound guided group (U) and experiential puncture group (E),). The patients in the experience puncture group were treated with needle knife through the doctor's experience, and the patients in the ultrasonic guidance group were treated with water needle knife under the guidance of ultrasound. All the patients were treated before, 1 week and 1 month after treatment. Oswestry function index (oswestry disability index,ODI) and neurologic function (Japanese Orthopaedic Association,JOA (Japanese Orthopaedic Association,JOA) were evaluated by visual analogue score (Visual Analogue Scale/Score,VAS) and neurologic function index (Japanese Orthopaedic Association,JOA) respectively. Adverse reactions were observed and VAS score, ODI value and therapeutic effect were statistically analyzed before and after treatment. Results: there was no significant difference in age, sex and course of disease between the two groups. The two groups of patients before and after treatment were significantly improved before and after treatment, compared with before treatment, the difference was statistically significant (P0.05); There was no significant difference in VAS score, ODI score and JOA score between the two groups before treatment (P0.05), but the VAS score and ODI value in the ultrasound guided group were significantly lower than those in the experience group. The JOA score of ultrasound guided group was higher than that of experience puncture group at each time point, the difference was statistically significant (P0.05). No serious complications occurred during follow-up in all patients. Conclusion: the treatment of lumbar intervertebral disc herniation with ultrasonic guided water needle knife has high accuracy and low adverse reaction, and it is helpful to improve the curative effect on the patients with lumbar intervertebral disc herniation. Ultrasonic guided water needle knife therapy is a safe, reliable and visual treatment method, which is worth popularizing in clinic.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9
，
本文编号：2321730
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