G型臂辅助下等离子射频消融术联合臭氧治疗包容型腰椎间盘突出症的临床观察及其复发的影响因素分析  

Clinical observation of G-arm assisted plasma radiofrequency ablation combined with ozone in the treatment of inclusive lumbar disc herniation and analysis of the influencing factors of recurrence

作　　者：黄磊[1] 石可松[1] 焦权明[1] 张涛[1] 孟朋 Huang Lei;Shi Kesong;Jiao Quanming;Zhang Tao;Meng Peng(Department of Third Orthopedics,Beijing Changping Hospital of Integrated Chinese and Western Medicine,Beijing 102208,China)

机构地区：[1]北京市昌平区中西医结合医院骨三科,102208

出　　处：《中华损伤与修复杂志（电子版）》2021年第3期232-238,共7页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：北京市昌平区卫生科技发展专项(昌卫科2018-2-14)。

摘　　要：目的观察G型臂辅助下等离子射频消融术联合臭氧治疗包容型腰椎间盘突出症的疗效,分析影响腰椎间盘突出症复发的相关因素。方法选择2017年5月至2019年7月北京市昌平区中西医结合医院骨科收治的包容型腰椎间盘突出症患者353例,按照随机数字表法分为微创手术治疗组 (n=180)和保守治疗组(n=173)。微创手术治疗组采用G型臂辅助下等离子射频消融术联合臭氧治疗,治疗1次,住院7 d为1个疗程;保守治疗组采用功能锻炼、对症止痛和物理治疗,1次/d,住院7 d为1个疗程。在治疗前,疗程结束后即刻,疗程结束后1、3、6、12个月采用视觉模拟评分法(VAS)观察疼痛改善情况,Oswestry功能障碍指数(ODI)评分评估疗效,比较2组的VAS、ODI评分;采用Logistic回归分析影响腰椎间盘突出症复发的影响因素。组间数据比较采用秩和检验或独立样 本t检验,组内数据比较采用配对样本t检验。结果失访21例,失访率为5.9%,其中微创手术治疗组失访9例,保守治疗组失访12例。微创手术治疗组、保守治疗组疗程结束后即刻与治疗前VAS评分比较,差异均有统计学意义 (t=3.15、2.73,P=0.013、0.032);治疗前,微创手术治疗组与保守治疗组VAS评分比较,差异无统计学意义 (t=0.66,P=0.596);疗程结束后即刻,疗程结束后1、3、6、12个月微创手术治疗组的VAS评分分别为(3.22±0.76)、(2.66±1.05)、(2.07±1.14)、(2.10±0.96)、(2.32±1.15)分,与保守治疗组[(4.07±1.37)、(3.76±1.14)、(2.63±1.17)、(2.63±1.41)、(3.23±1.21)分]比较,差异均有统计学意义 (t=3.09、2.75、2.46、2.11、1.96,P=0.004、0.029、0.043、0.045、0.042)。微创手术治疗组、保守治疗组疗程结束后即刻与治疗前ODI得分比较,差异均有统计学意义(t=2.75、2.73,P=0.003、0.011);治疗前,微创手术治疗组与保守治疗组ODI得分比较,差异无统计学意义(Z=1.63,P=0.632);疗程结束后即刻,疗程结束后1、3、6、12个月微�Objective To observe the effect of G-arm assisted plasma radiofrequency ablation combined with ozone in the treatment of inclusive lumbar disc herniation(LDH),and to analyze the relevant factors that affect the recurrence of LDH. Methods A total of 353 patients with inclusive LDH who were admitted to the Department of Third Orthopedics,Beijing Changping Hospital of Integrated Chinese and Western Medicine from May 2017 to July 2019 were divided into minimally invasive surgery treatment group( n =180)and conservative treatment group( n =173)according to the random number table method.The minimally invasive surgical treatment group was treated with plasma radiofrequency ablation assisted by G-arm combined with ozone therapy,the patients were treated once and hospitalized for 7 days as a course of treatment.The conservative treatment group used functional exercise,symptomatic analgesia and physical therapy,once a day,7 days of hospitalization as a course of treatment.Before treatment,immediately after the course of treatment,1,3,6,and 12 months after the course of treatment,the visual analogue scale(VAS)was used to observe the improvement of pain,the Oswestry dysfunction index(ODI)score was used to evaluate the effect,and the VAS and ODI scores of the two groups were compared.Logistic regression was used to analyze the factors affecting the recurrence of lumbar intervertebral LDH.Rank sum test or independent-sample t test was used for data between groups,and paired-sample t -test was used for data within groups. Results Twenty-one cases were lost to follow-up,the rate of loss to follow-up was 5.9%,including 9 cases in the minimally invasive surgery group and 12 cases in the conservative treatment group.The minimally invasive surgical treatment group and conservative treatment group immediately after the end of the course of treatment compared with the VAS score before treatment,the differences were statistically significant(t=3.15,2.73;P=0.013, 0.032).Before treatment,there was no significant difference in VAS score

关 键 词：导管消融术 臭氧 椎间盘移位 自助装置 复发 

分 类 号：R681.53[医药卫生—骨科学]