CT引导下化学消融术治疗腰椎间盘突出症的临床研究  

CT-guided chemoablation in treating lumbar disc herniation:a randomized controlled study

作　　者：张皓 杨茂江[2] 琼仙 李豪胜 

机构地区：[1]重庆市垫江县人民医院放射科,408300 [2]川北医学院附属医院放射科,四川南充637000

出　　处：《重庆医学》2017年第36期5109-5111,共3页Chongqing medicine

摘　　要：目的研究腰椎间盘化学消融术治疗腰椎间盘突出症(LDH)的临床疗效,为临床治疗提供参考。方法把191例LDH患者分为A、B两组,在CT引导下行腰椎间盘化学消融术治疗LDH,A组(n=95)行盘内注射治疗,B组(n=96)行盘内盘外联合注射治疗,术后30、90、180d通过门诊或电话等方式随访,参考Macnab疗效评定标准对患者做随访和统计分析。结果两组分别于治疗结束后30、90及180d进行门诊或电话随访,所有患者均未出现神经、脊髓损伤及椎间盘感染等并发症。视觉模拟评分法(VAS)评分系统,组内比较治疗前、后两组差异均有统计学意义(P<0.05),组间比较治疗后B组评分均低于A组(P<0.05)。A组优良率术后30d为81.1%(77/95),术后90d为83.2%(79/95),术后180d为85.3%(81/95);B组优良率术后30d为85.4%(82/96),术后90d为88.5%(85/96),术后180d为91.7%(88/96)。结论 CT引导下腰椎间盘微创介入化学消融术止痛效果良好、迅速,盘内外联合治疗疗效更好。Objective To investigate the clinical effectiveness of chemoablation for the treatment of lumbar disc herniations（LDH）to provide reference for its clinical treatment.Methods A total of 191 cases of LDH were divided into the group A and B.All cases were performed the CT-guided chemoablation for treating LDH.The group A conducted the intra-disc injection treatment,while the group B conducted the intra-disc and extra-disc combined injection.The cases were followed up by the modes of outpatient department or telephone on postoperative 30,90,180 d.The follow up and statistical analysis were conducted by referring to the Macnab effect evaluation criteria.Results The two groups conducted the outpatient department follow up or telephone follow up on postoperative 30,90,180 d.All cases did not appear the complications such as nerve damage,spinal cord damage and intervertebral disc infection.In the intra-group comparison,the VAS score had statistical difference between before and after treatment（P〈0.05）.In the inter-group comparison,the score after treatment in the group B was lower than that in the group A（P〈0.05）.The good effect rate on postoperative 30 din the group A was 81.1%（77/95）,which on postoperative 90 dwas 83.2%（79/95）and which on postoperative 180 dwas 85.3%（81/95）.The good effect rate in the group B was 85.4%（82/96）on 30 d,88.5%（85/96）on 90 dand 91.7%（88/96）on 180 d.Conclusion CT-guided lumbar intervertebral disc minimally invasive interventional chemoablation has good and rapid analgesic effect,and the intra-disc and inter-disc combined treatment has better curative effect.

关 键 词：体层摄影术 X线计算机 椎间盘化学松解术 椎间盘移位 

分 类 号：R681.53[医药卫生—骨科学]