腰椎间盘突出症行UBE内镜下髓核摘除术后连续臭氧椎管内注射的疗效观察

Observation on the curative effect of continuous ozone intraspinal injection after UBE endoscopic removal of nucleus pulposus for lumbar disc herniation

目的 观察腰椎间盘突出症(LDH)患者行单侧双通道内镜技术(UBE)内镜下髓核摘除术后连续臭氧椎管内注射治疗的疗效。方法 选取60例腰椎间盘突出症患者,随机分为观察组和对照组,各30例。所有患者均行UBE内镜下髓核摘除术,观察组术后连续臭氧椎管内注射治疗,对照组常规切口缝合、覆盖无菌辅料。比较两组手术前后腰腿痛评分及术后切口肿胀和渗出评分。结果 对照组术前1 d及术后1、5、12 d的视觉模拟评分法(VAS)评分分别为(6.65±1.59)、(5.13±1.18)、(3.92±1.15)、(2.28±1.18)分,观察组分别为(6.62±1.15)、(3.87±1.27)、(2.31±1.10)、(1.11±0.92)分;两组术前1 d VAS评分比较差异无统计学意义(P>0.05);术后1、5、12 d,两组VAS评分均低于术前1 d,且观察组均低于对照组,差异有统计学意义(P<0.05)。对照组术后1、5、12 d的肿胀评分和渗出评分分别为(2.16±0.58)、(1.33±0.79)、(0.42±0.12)分和(2.31±0.63)、(1.60±0.27)、(0.91±0.29)分,观察组分别为(1.82±0.47)、(0.89±0.83)、(0.15±0.16)分和(1.95±0.58)、(1.32±0.21)、(0.43±0.21)分;术后5、12 d,两组肿胀评分和渗出评分均低于术后1 d,差异有统计学意义(P<0.05);术后12 d,两组肿胀评分和渗出评分均低于术后5 d,差异有统计学意义(P<0.05);观察组术后1、5、12 d肿胀评分和渗出评分均低于对照组,差异有统计学意义(P<0.05)。结论 腰椎间盘突出症行UBE内镜下髓核摘除术后连续臭氧椎管内注射,可有效改善患者腰腿痛症状,且切口肿胀和渗出情况较轻,值得在临床上推广应用。

Objective To observe the curative effect of continuous ozone intraspinal injection after unilateral biportal endoscopy(UBE)endoscopic removal of nucleus pulposus for lumbar disc herniation(LDH).Methods 60 patients with lumbar disc herniation were randomly divided into an observation group and a control group,with 30 patients in each group.all of which underwent UBE endoscopic removal of nucleus pulposus.The observation group was treated with continuous ozone intraspinal injection after surgery,while the control group was treated with routine incision suture and covered with sterile dressing.The lumbago and leg pain score before and after surgery,incision swelling score and exudation score after surgery were compared between the two groups.Results The visual analogue scale(VAS)scores of the control group 1 d before surgery and 1,5 and 12 d after surgery were(6.65±1.59),(5.13±1.18),(3.92±1.15),and(2.28±1.18)points,and those of the observation group were(6.62±1.15),(3.87±1.27),(2.31±1.10),and(1.11±0.92)points.There was no statistically significant difference in VAS scores between the two groups 1 d before surgery(P>0.05).1,5 and 12 d after surgery,VAS scores in both groups were lower than those 1 d before surgery,and the observation group was lower than the control group;the difference was statistically significant(P<0.05).The swelling scores and exudation scores of the control group were(2.16±0.58),(1.33±0.79),(0.42±0.12)points and(2.31±0.63),(1.60±0.27),(0.91±0.29)points 1,5 and 12 d after surgery,and those of the observation group were(1.82±0.47),(0.89±0.83),(0.15±0.16)points and(1.95±0.58),(1.32±0.21),(0.43±0.21)points.5 and 12 d after surgery,the swelling scores and exudation scores in both groups were lower than those 1 d after surgery,and the difference was statistically significant(P<0.05).12 d after surgery,the swelling scores and exudation scores of the two groups were lower than those 5 d after surgery,and the difference was statistically significant(P<0.05).The swelling scores and exudation scores of the observation group 1, 5 and 12 d after surgery were lower than those of the control group, and the difference was statistically significant (P<0.05). Conclusion After UBE endoscopic removal of nucleus pulposus for lumbar disc herniation, continuous ozone intraspinal injection can effectively improve the symptoms of lumbago and leg pain in patients with lumbar disc herniation, and the incision swelling and exudation are minor, which is worthy of clinical application.