经皮穿刺射频热凝联合针刀治疗老年性腰椎管狭窄症的疗效评价  

Therapeutic evaluation of percutaneous target radiofrequency thermocoagulation combined with needle knife techniques therapy in age-related lumbar spinal stenosis

作　　者：钟毓贤[1] 乔晋琳[1] 丁宇[1] 崔洪鹏[1] 向东东[1] 付本升[1] 倪伟刚[1] 杜薇[1] 

机构地区：[1]中国人民解放军海军总医院康复医学科暨疼痛诊疗中心,北京市100048

出　　处：《实用老年医学》2016年第1期69-72,共4页Practical Geriatrics

基　　金：北京市科学技术委员会资助课题:首都临床特色应用研究专项(Z131107002213058)

摘　　要：目的探讨射频结合针刀治疗老年性腰椎管狭窄症(LSS)的方法及其疗效。方法采用前瞻性研究方法,选取48例老年性LSS患者,随机分为4组,分别为射频治疗组(A)、针刀组(B)、射频结合针刀组(C)、椎板开窗手术组(D),每组12例。所有患者定期进行随访,分别于治疗后1月、6月及12月随访进行疗效评估,记录视觉模拟量表(VAS)评分、腰椎疾患日本骨科协会(JOA)评分,比较不同时点的手术指标及评分结果,并计算临床治疗有效率。结果 A、B、C组的手术时间、术中出血量、术后平均住院时间均显著低于D组(P均<0.05),C组术后各时间点VAS评分与D组无统计学差异(P>0.05),C组术后6月、12月的VAS评分显著低于A、B组(P<0.05)。4组治疗均有一定程度的临床疗效,B组总有效率为83.3%,其余3组总有效率均为91.7%。结论射频结合针刀治疗老年性LSS疗效肯定,安全可靠,值得推广。Objective To evaluate the treatment effect of radiofrequency thermocoagulation combined with needle knife techniques therapy for age-related lumbar spinal stenosis（ LSS）,and to explore the related clinical outcome.Methods A prospective study was conducted. Forty-eight patients of LSS were divided into four groups. Group A received percutaneous target radiofrequency thermocoagulation,group B receiving needle knife techniques,group C receiving percutaneous target radiofrequency thermocoagulation combined with needle knife techniques,group D receiving lamina windowing decompression. Indicators of perioperative period were recorded. And scores of Visual Analogue Scale（ VAS）and JOA were calculated and recorded 6 and 12 months after treatment. Results The operation time,amount of bleeding,average length of stay of group A,B and C were lower than those of group D（ P 〉0. 05）,and the VAS score of group C showed no significant difference compared with that of group D（ P 〈0. 05）. The VAS score of group C was lower than that of group A、B 6 or 12 months after treatment（ P 〈0. 05）. The total effective rate of group B was 83. 3%,which was different from that of group A,C,and D. Conclusions Percutaneous target radiofrequency thermocoagulation combined with needle knife techniques therapy has a positive effect in patients with age-related LSS.

关 键 词：腰椎管狭窄症 微创 针刀 

分 类 号：R681.5[医药卫生—骨科学]