發(fā)布時(shí)間：2018-12-13 11:11

【摘要】：目的:比較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(pán)突出癥的臨床不同療效。方法:本研究病例來(lái)源均為山西醫(yī)科大學(xué)第二醫(yī)院骨科住院治療腰椎間盤(pán)突出癥的患者,就診時(shí)間為2013年10月至2014年9月。在符合腰椎間盤(pán)突出癥診療標(biāo)準(zhǔn)及納入標(biāo)準(zhǔn)的患者中,選取40例腰椎間盤(pán)突出癥患者為研究對(duì)象(所有研究對(duì)象的操作均由同一醫(yī)師完成),分為兩組:等離子射頻消融結(jié)合臭氧治療組(A組,20例)、單純等離子射頻消融治療組(B組,20例)。分別對(duì)患者術(shù)前、術(shù)后1周、1個(gè)月、3個(gè)月、6個(gè)月進(jìn)行Macnab評(píng)定和VAS評(píng)分,比較、分析2種方法的療效。結(jié)果:1、Macnab評(píng)定標(biāo)準(zhǔn):1周后,A組優(yōu)良率為75%,B組優(yōu)良率為55%;1個(gè)月后,A組優(yōu)良率為85%,B組優(yōu)良率為60%;3個(gè)月后,A組優(yōu)良率為90%,B組優(yōu)良率為60%;6個(gè)月后,A組優(yōu)良率為95%,B組優(yōu)良率為65%。經(jīng)卡方檢驗(yàn),兩組之間優(yōu)良率比較,1周和1個(gè)月,3個(gè)月χ2值分別為0.11(P0.05),0.06(P0.05),0.03(P0.05)差別無(wú)統(tǒng)計(jì)學(xué)意義,六個(gè)月χ2值為0.02(P=0.04),差別有統(tǒng)計(jì)學(xué)意義。2、VAS評(píng)分:A組術(shù)前VAS評(píng)分8.15±1.42、術(shù)后1周為2.75±0.55、術(shù)后1個(gè)月為2.35±0.49、術(shù)后3個(gè)月為1.80±0.41、術(shù)后6個(gè)月為1.17±0.51,術(shù)前和術(shù)后6個(gè)月經(jīng)配對(duì)t檢驗(yàn),P0.05,差異有統(tǒng)計(jì)學(xué)意義。B組術(shù)前VAS評(píng)分為7.90±1.29,術(shù)后1周為3.00±0.46、術(shù)后1個(gè)月為2.6±0.75、術(shù)后3個(gè)月為1.95±0.60、術(shù)后6個(gè)月為1.54±0.60,術(shù)后6個(gè)月和術(shù)前經(jīng)配對(duì)t檢驗(yàn),P0.05,差異有統(tǒng)計(jì)學(xué)意義。A組與B組比較術(shù)前、術(shù)后1周、1個(gè)月VAS評(píng)分t檢驗(yàn)(P0.05),差異無(wú)統(tǒng)計(jì)學(xué)意義;術(shù)后3個(gè)月和6個(gè)月(P0.05),均有統(tǒng)計(jì)學(xué)意義。結(jié)論:等離子射頻消融結(jié)合臭氧術(shù)治療腰椎間盤(pán)突出癥較單純等離子射頻消融術(shù)治療椎間盤(pán)突出癥療效更加顯著,且中遠(yuǎn)期療效更穩(wěn)定。
[Abstract]:Objective: to compare the clinical effects of plasma radiofrequency ablation (RFA) and radiofrequency ablation (RFA) combined with ozone in the treatment of lumbar disc herniation. Methods: all the patients were admitted to the Department of Orthopaedics of the second Hospital of Shanxi Medical University for lumbar disc herniation from October 2013 to September 2014. Of the patients who met the criteria for diagnosis and treatment of lumbar disc herniation, 40 patients with lumbar disc herniation were selected as subjects (all subjects were operated by the same physician). They were divided into two groups: plasma radiofrequency ablation combined with ozone therapy group (group A, 20 cases) and simple plasma radiofrequency ablation group (group B, 20 cases). The patients were evaluated with Macnab and VAS before operation, 1 week, 1 month, 3 months and 6 months after operation. Results: 1 Macnab evaluation standard: after 1 week, the excellent and good rate of group A was 75 and that of group B was 550.After one month, the excellent and good rate of group A was 85 and that of group B was 60. After 3 months, the excellent and good rate of group A was 90 and that of group B was 600.After 6 months, the excellent and good rate of group A was 95 and that of group B was 65. After chi-square test, the excellent and good rates of the two groups were 0.11 (P0.05), 0.06 (P0.05), 0.03 (P0.05), respectively. The VAS score of group A was 8.15 鹵1.42 before operation, 2.75 鹵0.55 at 1 week after operation and 2.35 鹵0.49 at 1 month after operation. It was 1.80 鹵0.41 in 3 months after operation and 1.17 鹵0.51 in 6 months after operation. There was a significant difference between pre-and post-operative menses matching t test (P0.05). The preoperative VAS score of group B was 7.90 鹵1.29, and that of group B was 3.00 鹵0.46 at 1 week after operation. It was 2.6 鹵0.75 in 1 month, 1.95 鹵0.60 in 3 months, 1.54 鹵0.60 in 6 months after operation. The difference was statistically significant between group A and group B by paired t test at 6 months and before operation (P 0.05). After 1 week, 1 month VAS score t test (P0.05), the difference was not statistically significant; Postoperative 3 months and 6 months (P0.05), there was statistical significance. Conclusion: plasma radiofrequency ablation combined with ozone in the treatment of lumbar disc herniation is more effective than plasma radiofrequency ablation alone in the treatment of disc herniation.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R687.3

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