【摘要】：目的C臂引導(dǎo)下對比研究經(jīng)皮靶點射頻熱凝消融聯(lián)合臭氧注射與單純射頻熱凝治療腰椎間盤突出癥的短期內(nèi)疼痛緩解情況和功能改善情況。分析探討經(jīng)皮靶點射頻熱凝聯(lián)合臭氧注射治療腰椎間盤突出癥(Lumbar disc herniation,LDH)的短期臨床療效。方法納入自2015年10月至2016年10月期間符合條件的LDH住院患者40名,隨機分為A、B兩組,每組20例,A組采用靶點射頻熱凝聯(lián)合臭氧注射治療,B組采用單純靶點射頻熱凝術(shù)治療。其中:A組男性14例,女性6例,平均年齡(39.19±6.87)歲,體質(zhì)指數(shù)(23.28±1.88)Kg/m2,平均病史(3.94±1.97)月,腰椎間盤突出癥發(fā)病節(jié)段均為單一節(jié)段,其中L3/4 5例,L4/5 12例,L5/S1 3例。B組男性12例,女性8例,平均年齡(38.92±7.13)歲,體質(zhì)指數(shù)(23.36±1.90)Kg/m2,平均病程(3.68±1.82)月,腰椎間盤突出癥發(fā)病節(jié)段L3/4 5例,L4/5 11例,L5/S1 4例。兩組患者一般資料比較具有可比性,差異無統(tǒng)計學(xué)意義(P0.05)。兩組患者均進行術(shù)前檢查并采用數(shù)值疼痛強度評定量表評分(Numerical Rating Scale,NRS)、Oswestry功能障礙指數(shù)問卷表評分(Oswestry Disability Index,ODI)及直腿抬高角度(angle of straight leg raising,SLR)進行評定。在術(shù)后即刻、術(shù)后3天、術(shù)后1周、術(shù)后1個月應(yīng)用NRS評分、ODI評分、直腿抬高試驗及改良Macnab進行療效評價(觀察優(yōu)良率)進行術(shù)后評定。所有病例均由1名骨科醫(yī)師操作完成。應(yīng)用SPSS 16.0統(tǒng)計軟件對所得數(shù)據(jù)進行統(tǒng)計學(xué)分析。結(jié)果所有納入病例均順利完成隨訪,有效隨訪率100%。兩組患者均未出現(xiàn)椎間盤炎、終板炎等并發(fā)癥。兩組患者術(shù)前NRS評分(8.40±0.94vs8.40±0.82)、ODI評分(48.0±1.21vs48.2±1.01)、SLR(37.5±9.25vs35.0±9.73)比較,差異無統(tǒng)計學(xué)意義(P0.05)。與術(shù)前比較,A、B兩組術(shù)后NRS評分、ODI評分下降,SLR均升高(P0.05)。A、B兩組間比較,術(shù)后A組患者NRS評分、ODI評分均低于B組,差異有顯著統(tǒng)計學(xué)意義(P0.05);A組患者術(shù)后SLR顯著高于B組,差異有顯著統(tǒng)計學(xué)意義(P0.05)。術(shù)后改良Macnab療效評定:術(shù)后即刻、術(shù)后3天兩組間差異不具有統(tǒng)計學(xué)意義(P0.05),術(shù)后1周,術(shù)后1個月A組優(yōu)良率顯著高于B組,兩組間差異具有統(tǒng)計學(xué)意義(P0.05)。結(jié)論在準確把握適應(yīng)癥與禁忌癥的前提下,靶點射頻熱凝聯(lián)合臭氧注射治療腰椎間盤突出癥比單純使用靶點射頻熱凝消融治療腰椎間盤突出癥效果好。聯(lián)合治療術(shù)后恢復(fù)快,安全可靠,短期內(nèi)的疼痛緩解和功能改善情況較好,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 鹵6.87) years, body mass index (BMI) of (23.28 鹵1.88) kg / m2 and mean history of (3.94 鹵1.97) months. The mean age was (38.92 鹵7.13) years, body mass index (BMI) was (23.36 鹵1.90) kg / m2, mean course of disease was (3.68 鹵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 鹵0.94vs8.40 鹵0.82) and (48.0 鹵1.21vs48.2 鹵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.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R681.53

【參考文獻】

相關(guān)期刊論文 前10條

1 周謀望;岳壽偉;何成奇;張長杰;馬誠;王惠芳;王楚懷;田峻;白躍宏;朱珊珊;劉宏亮;牟翔;李建華;楊衛(wèi)新;宋林;唐金樹;梁英;謝青;張芳;周云;黃澎;潘鈺;谷莉;李濤;邢華醫(yī);劉小燮;;“腰椎間盤突出癥的康復(fù)治療”中國專家共識[J];中國康復(fù)醫(yī)學(xué)雜志;2017年02期

2 郭艮春;馬飛翔;張桂芳;;美式整脊療法治療產(chǎn)后腰骶痛的臨床觀察[J];中國臨床研究;2017年01期

3 朱峻松;沈玉杰;王宇;瞿秀;王磊;;射頻靶點熱凝治療腰椎間盤突出癥對外周血中TNF-α和IL-1β的影響[J];中國醫(yī)藥導(dǎo)報;2016年30期

4 郭應(yīng)強;周莉莉;李娟;萬麗;;腰椎間盤突出癥射頻鎮(zhèn)痛的應(yīng)用效果研究[J];中國現(xiàn)代藥物應(yīng)用;2016年20期

5 何秀花;付宇;;微創(chuàng)射頻熱凝術(shù)治療腰椎間盤突出癥的療效觀察[J];中國衛(wèi)生標準管理;2016年22期

6 蔡少康;尹晶;夏楊;張照慶;;經(jīng)皮椎間盤旋切術(shù)結(jié)合臭氧治療腰椎間盤突出癥術(shù)后“疼痛反跳”現(xiàn)象及遠期鎮(zhèn)痛療效的臨床分析[J];中國疼痛醫(yī)學(xué)雜志;2016年06期

7 喻燕波;張達穎;王志劍;顧麗麗;章勇;劉小健;;靶點射頻熱凝術(shù)治療青少年型腰椎間盤突出癥臨床療效觀察[J];當代醫(yī)學(xué);2015年35期

8 鄭昊龍;孫瑩杰;陳克研;李凱;黃明;;腰椎間盤突出癥微創(chuàng)治療研究進展[J];創(chuàng)傷與急危重病醫(yī)學(xué);2015年04期

9 高林翼;張蜀華;;單純等離子射頻消融術(shù)與等離子射頻消融結(jié)合臭氧術(shù)治療腰椎間盤突出癥的不同療效比較[J];中國社區(qū)醫(yī)師;2015年17期

10 劉超;唐國柯;黃慶華;;靶點射頻熱凝聯(lián)合臭氧與聯(lián)合藥物側(cè)隱窩注射治療腰椎間盤突出癥的臨床比較[J];中國地方病防治雜志;2014年S2期

相關(guān)碩士學(xué)位論文 前5條

1 曾小華;射頻熱凝治療腰椎間盤突出癥的實驗與臨床研究[D];廣州醫(yī)科大學(xué);2014年

2 馬迪;射頻熱凝聯(lián)合臭氧消融單針多靶點治療腰椎間盤突出癥臨床療效觀察[D];遼寧中醫(yī)藥大學(xué);2014年

3 谷雅;低溫等離子射頻消融復(fù)合臭氧介入治療椎間盤源性疼痛的對照觀察[D];天津醫(yī)科大學(xué);2012年

4 梁學(xué)良;遠紅外熱成像技術(shù)對射頻熱凝靶點消融術(shù)結(jié)合臭氧治療腰椎間盤突出癥臨床療效評估的初步研究[D];南方醫(yī)科大學(xué);2012年

5 伍建平;臭氧注射聯(lián)合射頻熱凝治療腰椎間盤突出癥的臨床觀察[D];山東大學(xué);2009年

，

本文編號：2182488