经皮椎间盘穿刺射频靶点热凝臭氧消融术治疗腰椎间盘突出症的疗效

Therapeutic effect of percutaneous radiofrequency target thermos-coagulation combined with ozone ablation for lumbar disc herniation

目的探讨经皮椎间盘穿刺射频靶点热凝臭氧消融术治疗腰椎间盘突出症(LDH)的疗效。方法选择2019-01至2022-04武警某部官兵就诊于武警海南总队医院疼痛科行射频热凝靶点术治疗LDH的84例,采用调查问卷的形式分别收集患者在术前,术后3 d、2周、6个月、1年的疼痛评分、日本骨科学会评分(JOA)、功能障碍指数、患者满意度,将术后各个时间点的指标和术前比较,分析射频靶点热凝臭氧消融术对患椎间盘突出症青年官兵的治疗效果。结果84例中,2例失访,3例在术后因为严重的疼痛和功能障碍在一年时间内行其他手术治疗。在术后3 d、2周、6个月、1年等4个随访时间点,疼痛评分(4.0±0.9,2.5±0.7,1.8±0.7,2.5±0.8)均显著低于术前评分(7.5±0.9)(P<0.05),术后2周和1年疼痛评分无统计学差异。在术后3 d、2周、6个月、1年,JOA评分(23.3±1.6,24.9±1.4,25.4±1.8,23.3±2.0)显著高于术前JOA评分(13.8±1.9)(P<0.05),术后3 d和1年的JOA评分无统计学差异。患者功能障碍指数术后4个随访时间点(31.8±5.7,18.1±5.3,17.1±3.8,27.5±5.8)较术前(68.2±9.2)显著下降(P<0.05),功能障碍指数术后2周和6个月无统计学差异。患者在术后3 d、2周、6个月、1年的治疗满意度分别为74.7%、87.3%、88.6%、84.8%。结论经皮椎间盘穿刺射频靶点热凝臭氧消融术对于青年官兵的腰椎间盘突出症具有良好疗效。

Objective To study the curative effect of percutaneous radiofrequency target thermos-coagulation combined with ozone ablation for lumbar disc herniation in young soldiers.Methods Eighty-four patients with lumbar disc herniation(LDH)who were treated by radiofrequency thermos-coagulation surgery in the Pain Department of Hainan Provincial Corps Hospital of Chinese People’s Armed Police Force from January 2019 to April 2022 were selected.The pain score,JOA score,Oswestry disability index and the treatment satisfaction of the patients before surgery,3 days,2 weeks,6 months,and 1 year after surgery were collected by questionnaire,to analyze the therapeutic effect of radiofrequency target thermos-coagulation combined with ozone ablation on young soldiers with lumbar disc herniation.Results Among the 84 cases,2 cases were lost to follow-up,and 3 cases underwent other surgical treatments within one year due to severe pain and dysfunction after surgery.At the 4 follow-up time points of 3 days,2 weeks,6 months,and 1 year after surgery,the pain scores(4±0.9,2.5±0.7,1.8±0.7,2.5±0.8)were significantly lower than the preoperative scores(7.5±0.9)(P<0.05).There was no statistically significant difference in pain scores between 2 weeks and 1 year after surgery.At 3 days,2 weeks,6 months,and 1 year after surgery,the JOA scores(23.3±1.6,24.9±1.4,25.4±1.8,23.3±2.0)were significantly higher than the preoperative ones(13.8±1.9)(P<0.05).There was no statistically significant difference in JOA scores between 3 days and 1 year after surgery.At four follow-up time points after surgery,the patient’s dysfunction index significantly decreased from 68.2±9.2 to 31.8±5.7,18.1±5.3,17.1±3.8 and 27.5±5.8(P<0.05).There was no statistically significant difference in Oswestry disability index between 2 weeks and 6 months after surgery.The treatment satisfaction rates of patients at 3 days,2 weeks,6 months,and 1 year after surgery were 74.7%,87.3%,88.6%and 84.8%respectively.Conclusions Percutaneous radiofrequency target thermos-coagulation combined with ozone ablation for lumbar disc herniation in young soldiers is characterized by a good therapeutic effect.