DSA引导臭氧联合射频热凝术治疗颈椎间盘突出症的临床评价

CLINICAL EVALUATION OF DSA-GUIDING COMBINED USE OF OXYGEN-OZONE THERAPY WITH PERCUTANEOUS INTRADISCAL RADIOFREQUENCY THERMOCOAGULATION FOR THE TREATMENT OF CERVICAL DISC HERNIATIONS

目的：评价数字减影血管造影（digital subtraction angiography,DSA）引导经皮穿刺椎间盘臭氧联合射频热凝术治疗颈椎间盘突出症的临床疗效与安全性。方法：回顾性分析49例颈椎间盘突出症患者,分为两组：DSA引导经皮椎间盘臭氧联合射频热凝术组（O组,n=30）,在DSA引导下行经皮椎间盘射频热凝术,5 min后经射频针于椎间盘内注射臭氧（浓度：40 ug/ml）5~8 ml;DSA引导经皮椎间盘射频热凝术组（P组,n=19）,仅行颈椎间盘射频热凝术。根据疼痛视觉模拟评分量表（visual analogue scale,VAS）、改良MacNab评价法及患者满意度指标,在术后2周、1个月、3个月评估临床疗效,观察患者不良反应。结果：两组患者术后VAS评分与基线值相比均显著下降（P〈0.05）,O组患者VAS评分较P组在2周、1个月、3个月显著降低（P〈0.05）;O组优良率在2周,1个月,3个月显著高于P组（P〈0.05）;O组患者满意度较P组显著提高（P〈0.05）。两组患者均无严重不良反应发生。结论：DSA引导经皮椎间盘臭氧联合射频热凝术治疗颈椎间盘突出症能更有效地降低患者疼痛评分,改善患者颈肩功能;患者满意度高于单纯经皮椎间盘射频热凝术。DSA引导下两种治疗方法的安全性均较高。

Objective： To evaluate the efficacy and security of DSA-guiding combined use of oxygen-ozone therapy with percutaneous intradiscal radiofrequency thermocoagulation（PIRFT） for the treatment of cervical disc herniations.Methods： To analyze retrospectively the clinical material about 49 cases of patients with cervical disc herniations into two groups.P group（n = 19） received DSA-guiding PIRFT;O group（n = 30） received a combination of oxygen-ozone therapy after PIRFT.Primary outcome measures included visual analogue scale（VAS） for pain and the modified MacNab evaluation method,complication and patient＇s satisfaction.Clinical assessment of these outcome measures was performed at 2 weeks,1 month,3 months after the treatment.Results： VAS scores after treatment were significantly decreased compared with the baseline in both groups at all time points of follow-up;however,O group showed a significant reduction in the VAS scores compared to P group at 2 weeks,1 month and 3 months after treatment.O group showed a significant difference in modified MacNab evaluation compared to P group at 2 weeks,1 month and 3 months after treatment.O group also showed significantly greater patient satisfaction at all time points of follow-up compared with P group.There was no complication in each group.Conclusion： DSA-guiding ozone-PIRFT is more efficacious than PIRFT alone in reducing pain scores,improving functional outcome,and satisfaction of patients with cervical disc herniations.Ozone-PIRFT is a safe and efficacious treatment.