猪椎间盘臭氧髓核消融术联合多极射频消融后髓核变化的研究  

Changes in nucleus following ozone ablation combined with multi-polar radiofrequency ablation

作　　者：徐文科 毕国玺 袁庆杰 刘国兴 

机构地区：[1]潍坊市肿瘤专科医院(寒亭区人民医院),山东261100

出　　处：《当代医学》2010年第35期739-744,共6页Contemporary Medicine

摘　　要：目的了解臭氧髓核消融术联合多极射频消融术后猪椎间盘髓核的变化,寻求预防椎间盘突出症臭氧髓核消融术后复发的方法,从而进一步指导临床工作。方法分别对4条新鲜猪脊柱离体标本进行标记,猪A(对照组)、猪B(臭氧组)、猪C(臭氧联合射频5min组)、猪D(臭氧联合射频10min组)。首先对猪A、猪B、猪C进行CT、MR检查,每条脊骨做L1-2、L2-3、L3-4、L4-5、L5-S1五节椎间盘,留作对比,然后分别对猪B、猪C、猪D的L1-2、L2-3、L3-4、L4-5、L5-S1椎间盘进行臭氧髓核消融术,每节椎间盘注入O2-O3的混合气体20ml(臭氧浓度为60mg/L)。结束后立即对猪C、猪D的L1-2、L2-3、L3-4、L4-5、L5-S1椎间盘再行多极射频消融,参数设为能量上限150W、温升速率15℃/min、最高温度90℃、猪C消融时间5min、猪D消融时间10min。术后首先对猪B、猪C椎间盘行CT、MR检查,然后采集猪A、猪B、猪C、猪D椎间盘髓核标本,拍摄图像后再行组织病理学检查,最后对结果分四方面(CT、MR、大体标本、组织病理学)进行横向、纵向对比,分析、总结后得出结论。结果 1、CT表现:猪A诸椎间盘均未见空气密度影,猪B诸椎间盘术前均未见空气密度影,术后均见不规则空气密度影,猪C诸椎间盘术前均未见空气密度影,术后均见不规则空气密度影。2、MR表现:猪A诸椎间盘信号强度高,边缘规整,髓核轴位面积较大,猪B诸椎间盘术前椎间盘信号强度高,边缘规整,髓核轴位面积较大,术后较术前信号强度减低,边缘较术前欠规整,髓核轴位面积较术前缩小,猪C诸椎间盘术前椎间盘信号强度高,边缘规整,髓核轴位面积较大,术后较术前信号强度减低,边缘较术前欠规整,髓核轴位面积较术前缩小。3、大体标本:猪A诸椎间盘髓核光泽度强、无色、透明、韧性小,猪B诸椎间盘髓核术后髓核光泽度较强、无色、半透明、韧性较小,猪C诸椎间盘髓核术后髓核光泽�Objective To observe the changes in nucleus following ozone ablation combined with multi-polar radiofrequency ablation,explore preventive measures of recurrence,and make further helpful for clinical diagnosis and treatment.Materials and Methods：4 fresh pig backbones were isolated respectively：pigA（control group） pig B（the pig was treated with ozone） pig C（the pig was treated with ozone and RF 5min） pig D（the pig was treated with ozone and RF 10 min）.Firstly,all the intervertebral discs（L1-2、L2-3、L3-4、L4-5、L5-S1,IVDS） of pig A B and C received CT and MRI examination.Then all the IVDS of pig B、C、D were treated with Ozone nucleus ablation,every IVDS were injected 20ml mixed gas of O2-O3（ozone concentration was 60mg/L）.After this step,every IVDS of pig C D were treated with multipolar radiofrequecy cather ablation（multipolar RF）.Let RF parameters be energy upper limit 150W the temperature rise rate 15/min maximum temperature90 ablation time of pig C is 5 min,ablation time of pig D is 10min.After the operations,pig B and C received CT、MR examination and collecting specimen images and pathologic findings of all IVDS.Finally,make contrast analysis on four factors（CT、MR、general sample observation、histopathological examination） to get the conclusion Results 1 CT Manifestations IVDS of pig A has not find air density image.IVDS of pig B has not find air density image preoperatively,but can all find air density image postoperatively,IVDS of pig C has not find air density image both pre-operation and post-operation.2 MR Manifestations IVDS of pig A presented hypointensity border was regular nucleus axial area was large.IVDS of pig B presented hypointensity border was regular nucleus axial area was large preoperatively.After the operation,the signal intensity reduced,border became irregular,nucleus axial area was smaller than preoperation.IVDS of pig C presented hypointensity border was regular nucleu axial area was large preoperatively.After the operation,the signal inte

关 键 词：猪椎间盘 臭氧消融术联合多极射频消融术 多级射频 残存髓核毁损状况 CT、MR、病理变化 

分 类 号：R681.53[医药卫生—骨科学]