臭氧注射联合腰大肌间沟阻滞治疗腰椎间盘突出症的临床研究

Clinical research on the ozone injection plus psoas compartment block for the treatment of lumbar disc herniation

目的探讨经皮穿刺臭氧盘内注射联合腰大肌间沟阻滞治疗腰椎间盘突出症(LDH)的疗效及安全性。方法经临床检查和CT或MRI确诊为LDH患者68例,随机分为对照组和观察组各34例。均行C型臂X线机引导下臭氧消融治疗。观察组患者在臭氧消融术后进行腰大肌间沟阻滞治疗,对照组仅做臭氧消融术。治疗后1周、1个月,6个月分别采用VAS评分和改良MacNab法进行评价。结果治疗后1周、1个月、6个月的优良率在对照组分别为58.8%、70.6%、88.2%;在观察组分别为79.4%、85.3%、91.2%。两组在治疗后1周,1个月优良率均有显著性差异(P<0.05)。所有患者均未发现严重并发症。结论经皮穿刺臭氧盘内注射联合腰大肌间沟阻滞是一种有效、安全的微创方法,可以加速腰腿疼痛症状的改善,提高治疗LDH的近期疗效。

Objective To investigate the curative effect and safety of percutaneous intradisc injection of ozone combined with psoas compartment block （ PCB） for the treatment of lumbar disc herniation（ LDH）. Methods Sixty-eight patients with LDH confirmed by CT or MRI were randomly divided into control group （ CG,n =34） and observation group （ OG,n =34） ,and patients of both groups underwent C-arm X ray guided ozone ablation. The patients in OG received PCB after ozone ablation. In CG,the patients only received ozone ablation. Clinical outcome was assessed on the 7 d、30 d and 6 months after treatment according to visual analogue scale（ VAS） and the modified MacNab method. Results The excellent-good rate of 7 d、30 d、and 6 months after therapy in CG was 58. 8% 、70. 6% and 88. 2% respectively,and that in OG was 79. 4% 、85. 3% and 91. 2% respectively. There were significant differences between two groups in the excellent-good rate at 7 d and 30 d（ P 0. 05）. No serious complication occurred. Conclusion Percutaneous intradisc injection of oxone combined with PCB is an effective and safe method for the treatment of LDH. It improves the pain relief and the short-term clinical effects.