CT三维重建引导低温等离子射频消融联合臭氧及胶原酶治疗腰椎间盘突出症的疗效分析  

Clinical analysis of CT three-dimensional reconstruction guided low-temperature plasma radiofrequency ablation combined with ozone and collagenase in the treatment of lumbar disc herniation

作　　者：董蕊[1] 杨旭[1] 杜思扬 徐幼苗[1] 刘悦[1] 李丽梅[1] 赵健鑫 张志利[1] DONG Rui;YANG Xu;DU Si-yang(Department of Pain,Qinhuangdao First Hospital,Qinhuangdao Hebei 066000,China)

机构地区：[1]秦皇岛市第一医院疼痛科,河北秦皇岛066000

出　　处：《临床和实验医学杂志》2023年第9期991-994,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省卫计委课题(编号:20191380)。

摘　　要：目的探讨CT三维重建引导低温等离子射频消融联合臭氧和胶原酶治疗腰椎间盘突出症的疗效。方法回顾性选取2019年7月至2020年7月在秦皇岛市第一医院住院治疗的腰椎间盘突出症患者64例,根据治疗方案不同分为观察组和对照组,每组各32例。对照组采用CT三维重建引导低温等离子射频消融联合臭氧注射,观察组在对照组基础上行经骶裂孔入路胶原酶髓核溶解术,术后随访6个月。采用视觉模拟评分法(VAS)评估治疗前和治疗后3 d、1个月、3个月、6个月时疼痛程度。分别测定治疗前和治疗后3 d红细胞沉降率(ESR)、C反应蛋白(CRP)和白细胞计数(WBC)水平。采用改良Macnab标准评定临床疗效,计算治疗后1、3、6个月优良率。观察并记录两组患者随访期间并发症发生情况。结果治疗后,两组患者VAS评分较治疗前均大幅度降低,且观察组治疗后3、6个月时VAS评分为(1.91±1.15)、(1.47±0.76)分,均低于对照组[(3.75±1.50)、(2.38±1.04)分],差异均有统计学意义(P<0.05)。治疗后,两组患者ESR、CRP、WBC均增加,差异均有统计学意义(P<0.05),但两组治疗后上述指标比较,差异均无统计学意义(P>0.05)。观察组治疗后6个月的优良率为87.50%,高于对照组(65.63%),差异有统计学意义(P<0.05)。随访期间,所有患者均无软组织及椎管内血肿、神经受损、腰椎间盘感染等相关并发症发生。结论CT三维重建引导低温等离子射频消融联合臭氧和胶原酶治疗腰椎间盘突出症疗效确切,且安全性较高,具有临床应用价值。Objective To explore the curative effect of CT three-dimensional reconstruction guided low-temperature plasma radiofrequency ablation combined with ozone and collagenase in the treatment of lumbar disc herniation.Methods A total of 64 patients with lumbar disc herniation hospitalized in Qinhuangdao First Hospital from July 2019 to July 2020 were selected and divided into observation group and control group according to different treatment schemes,with 32 cases in each group.The control group was treated with CT three-dimensional reconstruction guided low-temperature plasma radiofrequency ablation combined with ozone injection,while the observation group was treated with collagenase nucleolysis via sacral hiatus approach on the basis of the control group,and followed up for 6 months.Visual analogue scale(VAS)was used to evaluate the degree of pain before treatment and 3 days,1 month,3 months and 6 months after treatment.The erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and white blood cell(WBC)counts were measured before and 3 days after treatment.The clinical curative effect was evaluated by modified Macnab standard,and the excellent and good rates were calculated at 1 month,3 months and 6 months after treatment.The complications of the two groups were observed and recorded during the follow-up period.Results After treatment,the VAS scores of the two groups were significantly lower than those before treatment,and the VAS scores of the observation group at 3 and 6 months after treatment were(1.91±1.15),(1.47±0.76)points,which were lower than those of the control group[(3.75±1.50),(2.38±1.04)points],the differences were statistically significant(P<0.05).After treatment,ESR,CRP and WBC of the two groups all increased,and the differences were statistically significant(P<0.05),but there were no statistically significant differences between the two groups after treatment(P>0.05).The excellent and good rate of the observation group 6 months after treatment was 87.50%,which was higher than that of the co

关 键 词：腰椎间盘突出症 CT三维重建 低温等离子射频消融 臭氧 胶原酶 

分 类 号：R681.53[医药卫生—骨科学]