低温等离子靶点消融术联合臭氧治疗神经根型颈椎间盘突出症的疗效  

Efficacy of low temperature plasma target ablation combined with ozone in treatment of radicular cervical disc herniation

作　　者：瞿群威[1] 沈玉杰[1] 朱峻松 柯洪奎 涂韶恒 余长江 QU Qunwei;SHEN Yujie;ZHU Junsong(Department of Pain Medicine,Affiliated Puren Hospital,Wuhan University of Science and Technology,Wuhan 430081,CHINA)

机构地区：[1]武汉科技大学附属普仁医院疼痛科,湖北430081

出　　处：《江苏医药》2021年第4期390-394,共5页Jiangsu Medical Journal

基　　金：湖北省卫生和计划生育委员会联合基金(WJ2018H0106)。

摘　　要：目的观察低温等离子靶点消融术联合臭氧治疗神经根型颈椎间盘突出症的疗效。方法神经根型颈椎间盘突出症患者111例分别采用低温等离子靶点消融术联合臭氧(观察组,74例)和低温等离子射频消融髓核成形术联合臭氧(对照组,37例)治疗。于术前、术后1 d、4 d、3个月和6个月时评估VAS疼痛评分和颈椎功能障碍指数(NDI),术后6个月采用改良MacNab疗效评定标准评估临床疗效,术前以及术后1 d、4 d、3个月时检测患者血清IL-6、IL-10水平。结果患者全部顺利完成手术,术后未有感染、血肿等并发症发生。两组患者在术后各时间点VAS疼痛评分和NDI均较术前下降(P<0.01),且术后3个月及6个月时观察组下降更明显(P<0.01)。两组患者术后血清IL-6水平较术前下降(P<0.01),且术后3个月时观察组下降更明显(P<0.01);术后4 d,两组血清IL-10水平高于术前(P<0.01),而在术后3个月时低于术前(P<0.01),且观察组在术后4 d和3个月时均高于对照组(P<0.01或P<0.05);两组在术后4 d和3个月时IL-10/IL-6比值高于术前(P<0.05或P<0.01),且观察组均高于对照组(P<0.05)。术后6个月,观察组优良率高于对照组(90.54%vs.67.57%)(P<0.01)。结论低温等离子靶点消融术联合臭氧治疗神经根型颈椎间盘突出症较低温等离子射频消融髓核成形术联合臭氧更能够有效减轻患者疼痛和调节IL-10/IL-6比值。Objective To observe the efficacy of low temperature plasma target ablation(LTPTA)combined with ozone in the treatment of radicular cervical disc herniation.Methods A hundred and eleven patients with radicular cervical disc herniation were treated with LTPTA combined with ozone(group A,74 cases)or low temperature plasma radiofrequency ablation and myeloplasty(LTRFAM)combined with ozone(group B,37 cases).The VAS pain score and neck disability index(NDI)were evaluated before(T0)and on the 1st day(T1)and 4th day(T2),in the 3rd month(T3)and 6th month(T4)after operation.The clinical efficacy was evaluated with modified MacNab criteria at T4.Serum levels of IL-6 and IL-10 were detected at T0,T1,T2 and T3.Results The operations in all the cases completed successfully without postoperative complications.The VAS pain score and NDI were lower after operation than those before(P<0.01),which at T3 and T4 were lower in group A than those in group B(P<0.01).Serum level of IL-6 was lower after operation than that before(P<0.01),which at T3 was lower in group A than that in group B(P<0.01).Serum level of IL-10 was higher at T2,but lower at T3 than that at T0(P<0.01),which at T2 and T3 was higher in group A than that in group B(P<0.01 and P<0.05).The ratio of IL-6 to IL-10 was higher at T2 and T3 than that at T0(P<0.01 and P<0.05),which was higher in group A than that in group B(P<0.05).The excellent rate at T4 was higher in group A than that in group B(P<0.01).Conclusion Compared to LTRFAM,LTPTA combined with ozone is more effective in alleviating the pain and adjusting the ratio of IL-6 to IL-10 in the treatment of radicular cervical disc herniation.

关 键 词：神经根型颈椎间盘突出症 低温等离子靶点消融术 低温等离子射频消融 髓核成形术 

分 类 号：R681[医药卫生—骨科学]