不同数量穿刺通道低温等离子髓核成形术治疗腰椎间盘突出症的疗效  

A clinical study on low-temperature plasma nucleoplasty with different number of puncture channels for lumbar disc herniation

作　　者：穆莹[1] 姚鹏[1] MU Ying;YAO Peng(Department of Pain Management,Shengjing Hospital,China Medical University,Shenyang 110000,China)

机构地区：[1]中国医科大学附属盛京医院疼痛科,沈阳110000

出　　处：《实用医学杂志》2021年第22期2882-2886,共5页The Journal of Practical Medicine

基　　金：辽宁省自然科学基金(编号:20170541032)。

摘　　要：目的对比不同数量穿刺通道低温等离子髓核成形术治疗腰椎间盘突出症的临床效果。方法选择行低温等离子髓核成形术的45例患者为研究对象,随机分为三组(组1为2通道组,组2为4通道组,组3为6通道组),利用VAS评分、ODI腰椎功能障碍评分、PPI疼痛强度评分、改良Macnab评分以及满意度评估患者手术前后疼痛程度及临床疗效。结果 45例患者手术均顺利完成,无不良反应。与术前相比,三组患者VAS评分在术后1 d、术后1周、术后1个月及术后3个月均明显降低(P<0.01),但组2及组3的VAS评分降低幅度较组1明显(F=4.219,P<0.01);与术前相比,三组患者ODI腰椎功能障碍评分均明显下降(P<0.01),组2及组3在术后1个月及术后3个月ODI评分下降幅度较组1明显(F=3.413,P<0.01);与术前相比,三组患者PPI评分均明显下降(P<0.05),三组各时间点PPI评分下降程度差异无统计学意义(F=1.327,P=0.233);术后3个月,三组患者改良Macnab评分及满意度均较高,对比差异无统计学意义(P>0.05)。结论综合考虑低温等离子髓核成形术术后患者疼痛恢复情况、腰椎功能恢复情况、手术复杂程度及潜在损伤等情况,低温等离子髓核成形术治疗腰椎间盘突出引起下肢神经痛手术可选择4通道手术方式。Objective To compare the clinical effects of low-temperature plasma nucleoplasty with different number of puncture channels in the treatment of lumbar disc herniation. Methods 45 patients who had received low-temperature plasma nucleoplasty patients were selected as research objects,and randomly divided into three groups(group 1 for 2-channel group,group 2 for 4-channel group,and group 3 for 6-channel group). The VAS score,ODI lumbar dysfunction score,PPI pain intensity score,modified Macnab score,and degree of satisfaction were used for assessing the preoperative and postoperative pain level and the clinical efficacy. Results The surgical procedures were successfully performed in 45 patients and no adverse reactions occurred. As compared with the baselines,the VAS scores were significantly decreased in the three groups on postoperative day 1,week 1,and months 1 and 3(P < 0.01),but they declined more significantly in groups 2 and 3 than in group 1(F = 4.219,P < 0.01);the ODI score was significantly decreased in the three groups(P < 0.01),and it was decreased more significantly in groups 2 and 3 than in group 1(F = 3.413,P < 0.01);the PPI score was significantly decreased in the three groups(P < 0.05),and there were no significant differences in the degree of PPI decline among the three groups at each time point(F = 1.327,P = 0.233);the modified MacNAB score and satisfaction degree were all higher in the three groups three months after surgery,and there were no significant differences(P > 0.05).Conclusions Considering the postoperative pain relief and functional recovery of the lumbar spine,surgical complexity and potential injury in patients receiving low-temperature plasma nucleoplasty,we suggest the four-channel surgical approach should be selected for the treatment of lower limb neuralgia caused by lumbar disc herniation.

关 键 词：低温等离子髓核成形术 腰椎间盘突出症 临床疗效 

分 类 号：R459.4[医药卫生—治疗学]