经皮穿刺臭氧注射椎间盘髓核消融术与经皮椎间盘内射频消融术治疗腰椎间盘突出症的临床疗效比较

Comparison of clinical efficacy of percutaneous ozone injection of intervertebral disc nucleus pulposus ablation and percutaneous radiofrequency ablation in the treatment of lumbar disc herniation

目的 比较经皮穿刺臭氧注射椎间盘髓核消融术与经皮椎间盘内射频消融术治疗腰椎间盘突出症的临床效果.方法 选取腰椎间盘突出症患者86例为研究对象.根据治疗方式差异,将患者分为两组：臭氧注射组（43例）、射频消融组（43例）.观察对比两组临床疗效、手术时间、住院时间、并发症发生情况、日本矫形外科学会（JOA）腰痛评分.结果 臭氧注射组优良率为81.4％,与射频消融组的83.7％差异无统计学意义（χ2=0.055,P〉0.05）;臭氧注射组手术时间及住院时间分别为（54.82±8.16）min、（7.86±1.57）d,均较射频消融组的（87.35±6.64）min、（11.51±1.29）d缩短（t=20.277、11.779,均P〈0.01）;两组均无并发症发生;两组术前、术后1周JOA评分差异无统计学意义（P〉0.05）;术后1个月、3个月射频消融组JOA评分分别为（22.83±1.81）分、（24.93±1.77）分,均较臭氧注射组的（19.09±2.27）分、（22.31±1.98）分增加（t=8.447、6.469,均P〈0.01）.结论 两种微创术式治疗腰椎间盘突出症均能取得一定效果,椎间盘内射频消融术对患者近期腰痛症状的改善优于经皮穿刺臭氧注射椎间盘髓核消融术,但手术时间及住院时间均长于臭氧注射术,故临床对治疗方式的选择需综合考虑.

 Objective To compare the clinical effect of percutaneous lumbar disc nucleus pulposus ablation and percutaneous radiofrequency ablation in the treatment of lumbar disc herniation .Methods 86 patients with lumbar disc herniation were selected as the research subjects .According to the difference of treatment ,the patients were randomly divided into two groups：ozone injection group （ 43 cases ） , radiofrequency ablation group （ 43 cases ） .The clinical efficacy,operation time,length of stay,complications,and low back pain score of Japanese Orthopaedic Association（JOA） were observed and compared between the two groups .Results The excellent rate of the ozone injection group was 81.4%,which of the radiofrequency ablation group was 83.7%（χ2 =0.055,P〉0.05）.The operation time and hospitalization time of the ozone injection group were （54.82 ±8.16） min,（7.86 ±1.57） days, respectively,which were shorter than those of the ablation group [（87.35 ±6.64） min,（11.51 ±1.29） days,t =20.277,11.779,all P〈0.01].There were no complications occurred in two groups .Before operation and 1 week after operation,the JOA score between the two groups had no statistically significant difference （P〉0.05）.After 1 month and 3 months,the JOA scores of radiofrequency ablation group were （22.83 ±1.81） points,（24.93 ± 1.77）points,which were higher than those of the ozone injection group [（19.09 ±2.27） points,（22.31 ± 1.98）points,t=8.447,6.469,all P〈0.01].Conclusion The two kinds of minimally invasive surgical treatment for lumbar disc herniation can achieve certain effect ,as to improve low back pain symptoms ,the intradiscal radiofre-quency ablation is superior to percutaneous injection of ozone nucleus pulposus ablation ,but the operation time and hospitalization time are longer than ozone injection ,so the clinical treatment options need to be considered .