射频热凝术联合硬膜外腔神经阻滞治疗腰椎间盘突出症的临床研究

Clinical study of radiofrequency thermocoagulation for treatment of lumbar intervertebral disc herniation

目的:观察射频热凝术联合硬膜外腔神经阻滞治疗腰椎间盘突出症(Lumbar interve rtebral disc herniation,LDH)的临床疗效及安全性。方法:102例LDH患者分为两组:射频热凝术联合硬膜外腔神经阻滞治疗组(R组,n=48):硬膜外腔单次注射镇痛复合液,1周后行腰椎间盘射频热凝术;硬膜外腔神经阻滞治疗组(E组,n=54):硬膜外腔注射镇痛复合液。治疗前后进行VAS评分,观察临床疗效、不良反应。结果:射频热凝术后1d、1周、1月两组患者VAS评分均明显降低,R组分别为3.13±0.99,1.35±0.34,1.05±1.22,E组分别为4.98±0.66、1.98±0.81、1.68±1.03,较治疗前均有显著性差异(P<0.01)。射频热凝术后1dR组优良率(75.0%)明显高于E组(53.7%);术后1月R组优良率(83.3%)仍高于E组(74.1%)。两组患者均无严重不良反应的发生。结论:射频热凝术联合硬膜外腔神经阻滞治疗是目前治疗LDH安全、有效的方法。

Objective： To observe the clinical efficacy and safety of radiofrequency thermocoagulation combined with epidural block for treatment of lumbar intervertebral disc herniation. Methods ： One hundred and two patients with Lumbar disc herniation were divided into two groups. Radiofrequency thermocoagulation combined with epidural block group （group R, n=48 ） accepted the epidural drugs injection o 1 week later radi- ofrequency thermocoagulation was taken . The epidural block group （group E,n=54） accepted the same epidural drugs injection. The VAS scores , clinical efficacy and complication were evaluated. Results： After the treatment, VAS scores in both groups decreased significantly compared with that before treatment. V？,S scores on day 1, week 1 and month 1 after radiofrequency thermocoagulation were 3.13 ±0.99,1.35 ±0.34, 1.05±1.22 respectively in the group R and 4.98±0.66,1.98 ± 0.81,1.68±1.03 respectively in the group E （ P〈0.01 ）. On the second day after radiofrequency thermocoagulation,the satisfactory rate was 75.0% in the group R,which was much better than 53.7% in the group E. One month after radiofrequency thermocoagulation,the curative satisfactory rate in the group R was 83.3% higher than 74.1% in the group E. Conclusion： Thermocoagulation combined with epidural block for treatment of lumbar intervertebral disc herniation is effective and safe.