低温等离子射频消融髓核成形术联合O_2-O_3椎间盘内外注射治疗LDH的临床研究

Therapeutic effect of coblation nucleoplasty combined with O_2-O_3 mixture injection within and outside intervertebral disc on lumbar disc herniation

目的探讨低温等离子射频消融髓核成形术联合O2-O3混合气体盘内外注射消融治疗腰椎间盘突出症(LDH)的临床疗效。方法选取120例腰椎间盘突出症患者,随机分3组,每组40例,射频治疗组(A组),O2-O3混合气体治疗组(B组),射频+O2-O3混合体治疗组(C组)。采用VAS视觉模拟疼痛评分作为疼痛水平评价指标,改良Macnab标准评估治疗效果。观察治疗后1周、2周、1个月、2个月VAS视觉模拟疼痛评分及术后2个月手术优良率。结果3组术后症状有不同程度的缓解,未发生不良反应及其他并发症。术后VAS疼痛分值C组低于其他2组(P<0.05),C组术后2个月优良率为97.5%,高于A组和B组(P<0.05);但A组与B组疼痛分值及术后2个月优良率差异无统计学意义(P>0.05)。结论低温等离子射频消融髓核成形术联合O2-O3混合气体盘内外注射消融治疗LDH安全有效,疗效优于单独应用射频消融或O-O消融术。

Objective To observe the therapeutic effect of coblation nucleoplasty combined with O2-O3 mixture injection within and outside intervertebral disc on lumbar disc herniation（LDH）. Methods 120 patients with LDH were randomly divided into three groups（40 cases in each group ）. The patients in group A were treated with coblation nueleoplasty, those in group B were treated with O2-O3 mixture, the patients in group C were treated with coblation nueleoplasty combined with O2-O3 mixture. Therapeutic effects were evaluated on 1 week ,2 weeks, 1 month and 2 months after treatment by using the average scores of VAS and Macnab＇ s method. Results The patients＇ symptoms in three groups were improved at different extents, without adverse reactions and other complications. The pain scores in group C were significantly lower than those in other two groups （ P 〈 0.05 ）. The effective rate in group C was 97.50% ,which was significantly higher than that in group A and group B（ P 〈 0.05 ）. However there was no significant difference in pain scores and effective rate between group A and group B （ P 〉 0.05 ）. Conclusion The eoblation nucleoplasty combined with O2-O3 mixture injection within and outside intervertebral disc is effective and safe in treating lumbar disc herniation, and the therapeutic effect is superior to that of using coblation nucleoplasty or O2-O3 mixture only.