【摘要】：目的:本研究通過評估患者在治療前后的臨床癥狀和體征方面和日常生活工作質量的變化,分析在超聲引導下水針刀治療腰椎間盤突出癥的安全性和臨床療效。以期找到一種安全、經濟及有效的治療方法,可以減輕患者的臨床癥狀,從而提高患者的生活質量。在臨床上加以推廣使用,同時為臨床上運用針刀治療腰椎間盤突出癥提供了一種新的思維。方法:選取2015年12月至2016年12月期間廣東省中醫(yī)院確診治療的腰椎間盤突出癥患者60例,依據隨機分配原則分為超聲引導組(U)和經驗穿刺組(E),每組30例,經驗穿刺組的患者憑醫(yī)師經驗下水針刀治療,超聲引導組的患者給予在超聲引導下水針刀治療,對所有患者治療前、治療后1周、1個月、3個月內應用視覺模擬評分法(Visual Analogue Scale/Score,VAS)進行疼痛評估 Oswestry 功能指數(oswestry disability index,ODI)及采用日本骨科醫(yī)師協(xié)會神經功能(Japanese Orthopaedic Association,JOA)進行評定,觀察不良反應發(fā)生情況,統(tǒng)計分析所有患者治療前后VAS評分、ODI值和治療效果。結果:在兩組患者中,患者治療前的年齡,性別,病程差別均無統(tǒng)計學意義。兩組患者治療前后的觀察指標均有明顯改善,與治療前比較,差異均有統(tǒng)計學意義(P0.05);治療前兩組患者VAS評分,ODI值及JOA評分差異無統(tǒng)計學意義(P0.05),但是超聲引導組患者各時點VAS評分及ODI值明顯低于經驗組,且超聲引導組各個時點的JOA評分均高于經驗穿刺組,差異有統(tǒng)計學意義(P0.05)。在所有患者隨訪過程中未出現嚴重并發(fā)癥。結論:應用超聲引導下水針刀治療腰椎間盤突出癥的準確度高、不良反應低,并且有助于提高對患者的療效。超聲引導下水針刀治療是一種安全,可靠及可視化的治療方法,值得臨床推廣應用。
[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.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.9
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本文編號：2321730