CT引导下射频联合臭氧治疗腰椎间盘突出症日间手术的疗效  

The clinical effect of day surgery for lumbar disc herniation using spiral CT guided ozone injection and radio frequency thermocoagulation

作　　者：廉凯龙 高京生[1] 贾子普 孟岚[3] 罗芳[3] 王涛[4] 丁金立 LIAN Kailong;GAO Jingsheng;JIA Zipu;MENG Lan;LUO Fang;WANG Tao;DING Jingli(Department of Radiology,Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Anesthesiology,Tiantan Hospital,Capital Medical University,Beijing 100070,China;Daytime Surgery Department,Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Neurosrugery,Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院放射科,北京100070 [2]首都医科大学附属北京天坛医院麻醉科,北京100070 [3]首都医科大学附属北京天坛医院日间手术部,北京100070 [4]首都医科大学附属北京天坛医院神经外科,北京100070

出　　处：《西部医学》2023年第8期1233-1238,共6页Medical Journal of West China

基　　金：北京市医管局青苗人才(QML20210505)。

摘　　要：目的 探讨螺旋CT引导下射频热凝联合臭氧消融治疗腰椎间盘突出症日间手术的临床疗效。方法 回顾性收集2020年1月—2022年6月我院日间病房住院的137例腰椎间盘突出症患者的临床资料,所有患者均行螺旋CT引导下射频联合臭氧消融治疗日间手术。收集手术时间,术毕至出院时间,总住院时间,术前、术后1月、3月的疼痛数字评分(NRS),Oswestry功能障碍指数(ODI)评分,改良Macnab评级和手术相关并发症,并进行术前与术后的对比分析。结果 所有患者在螺旋CT引导下穿刺成功率为100%,并在手术当日出院,平均手术时间为(35.55±10.44)min,平均术毕至出院时间为(58.36±25.26) min,平均总住院时间为(453.91±27.18)min。术后1、3月的NRS评分和ODI评分均低于术前;术后1、3月改良Macnab疗效评定标准有效率分别为86.13%、89.05%。所有患者均未有穿刺或治疗相关的并发症。结论 螺旋CT引导下射频联合臭氧消融治疗腰椎间盘突出症日间手术是可行的,其可降低腰椎间盘突出症患者的疼痛程度、改善日常功能障碍、安全性高,可在临床推广应用。Objective To explore the clinical efficacy of day surgery for lumbar disc herniation using spiral CT guided ozone injection and radiofrequency thermocoagulation.Methods The clinical data of 137 patients with lumbar disc herniation were collected retrospectively.Day surgery by using spiral CT guided ozone injection and radiofrequency thermocoagulation was applied for all patients.The surgery duration,mean length of hospital stay after surgery,and total hospital stay were recorded.Numerical rating Scale(NRS)and oswestry disability index(ODI),modified Macnab rating and postoperative complications one and three months later after the surgery were collected.The preoperative and postoperative data were statistically analyzed.Results The success rate of spiral CT guided puncture was 100%and all patients were discharged on the day of surgery.The mean surgery duration,mean length of hospital stay after surgery,and total hospital stay were(35.55±10.44)min,(58.36±25.26)min,and(453.91±27.18)min.The postoperative NRS and ODI were lower than preoperative NRS and ODI.The standard effective rates of modified Macnab one and three months after the day surgery were 86.13%and 89.05%.No postoperative complications were found.Conclusion The day surgery for lumbar disc herniation using spiral CT guided ozone injection and radiofrequency thermocoagulation is feasible,which is worth of popularization considering its advantages including reducing the patients'pain degree,improve their daily dysfunction,and high safety.

关 键 词：腰椎间盘突出症 日间手术 螺旋CT 射频热凝术 臭氧 

分 类 号：R681.53[医药卫生—骨科学]