臭氧联合射频消融治疗腰椎间盘突出症的效果及症状复发分析  

Analysis of the effect and symptom recurrence of ozone combined with radiofrequency ablation in the treatment of lumbar disc herniation

作　　者：陈晓微 卢伟 CHEN Xiaowei;LU Wei(Graduate School,Chengde Medical University,Hebei Province,Chengde 067000,China;Interventional Diagnosis and Treatment Center,Zhongnan Hospital of Wuhan University,Hubei Province,Wuhan 430071,China)

机构地区：[1]承德医学院研究生学院,河北承德067000 [2]武汉大学中南医院介入诊疗中心,湖北武汉430071

出　　处：《中国当代医药》2023年第26期4-8,F0004,共6页China Modern Medicine

基　　金：原海军总医院人才引进专项基金项目(rcyjzx-009);武汉大学中南医院介入诊疗中心发展规划项目(rcyj20210301)。

摘　　要：目的探究臭氧和臭氧联合射频消融术治疗腰椎间盘突出症(LDH)的效果及患者术后症状复发风险。方法回顾性选取2014年6月至2022年6月就诊于中国人民解放军总医院第六医学中心85例LDH患者作为研究对象,按照手术方式分为臭氧消融组(30例)和臭氧联合射频组(55例),分别采用日本骨科学会(JOA)手术评分标准、改良MacNab标准比较两组患者治疗效果,并应用竞争风险模型比较两组患者术后症状复发累计发生率。结果臭氧联合射频组术后1年内、1~<2年、2~4年、4年以上的JOA评分均值均高于前一个时间段,差异有统计学意义(P<0.05);臭氧消融组在术后1年内、1~<2年、2~4年、4年以上JOA评分均值比较,差异无统计学意义(P>0.05)。两组患者术后1年内JOA评分均值比较,差异有统计学意义(P<0.05);两组患者其他时间段术后JOA评分均值比较,差异无统计学意义(P>0.05)。两组患者随访截止点的改良MacNab有效率比较,差异无统计学意义(P>0.05)。臭氧联合射频组术后症状复发累计风险较臭氧消融组下降90%(SHR:0.10,95%CI:0.01~0.72,P=0.022)。结论臭氧联合射频消融术对LDH患者的疼痛及功能具有持久改善的作用,有效率更高,术后症状复发风险更低。Objective To explore the efficacy of ozone and ozone combined with radiofrequency ablation in the treatment of lumbar disc herniation(LDH)and the risk of postoperative symptom recurrence.Methods Eighty-five patients with LDH in the Sixth Medical Center of PLA General Hospital from June 2014 to June 2022 were retrospectively selected as research objects,and they were divided into ozone ablation group(30 cases)and ozone combined radiofrequency group(55 cases)according to surgical methods.The therapeutic effects of the two groups were compared according to the Japanese Orthopaedic Association(JOA)surgery score standard and the modified MacNab standard,and the cumulative incidence of postoperative symptom recurrence was compared between the two groups by competitive risk model.Results The average JOA score of ozone combined radiofrequency group within 1 year,1-2 years,2-4 years and more than 4 years after operation was higher than that of the previous time period,the differences were statistically significant(P<0.05).There were no significant differences in JOA scores within 1 year,1-2 years,2-4 years and more than 4 years after operation in ozone ablation group(P>0.05).There was significant difference in the average JOA score within 1 year after operation between the two groups(P<0.05).There were no significant differences in the average JOA score in other time periods between the two groups(P>0.05).There was no statistically significant difference in improved MacNab efficiency of the follow-up cutoff point in the two groups(P>0.05).The cumulative risk of postoperative symptom recurrence in the combined group was 90%lower than that in the ozone ablation group(SHR:0.10,95%CI:0.01-0.72,P=0.022).Conclusion Ozone combined with radiofrequency ablation has a lasting improvement on pain and function in patients with LDH,with a higher effective rate and a lower risk of postoperative symptom recurrence.

关 键 词：射频消融 臭氧 腰椎间盘突出症 复发 竞争风险模型 

分 类 号：R681.53[医药卫生—骨科学]