臭氧治疗椎间盘突出合并腰椎管狭窄症的临床研究

Clinical study of oxygen-ozone therapy in the treatment of patients with lumbar disc herniation complicated with lumbar spinal stenosis

目的探讨臭氧在椎间盘突出合并腰椎管狭窄患者中的治疗效果。方法回顾性分析我院骨科采用臭氧经皮注射治疗46例椎间盘突出合并腰椎管狭窄患者的临床资料。所有患者术后均进行严密随访6个月,并分别于术后1周、术后3个月及6个月时采用MacNab改良方法进行疗效评价,疼痛程度采用视觉模拟评分法(VAS)进行评分,比较不同时点的治疗效果。结果术后1周时显效率为80.4%(37/46),总有效率为93.5%(43/46);术后3个月时显效率为76.1%(35/46),总有效率为91.3%(42/46);术后6个月时显效率为76.1%(35/46),总有效率为89.1%(41/46);三个时点疗效比较差异无统计学意义(P均>0.05)。术后3个月VAS评分显著低于术前(P<0.01),术后6个月显著低于3个月(P<0.01)。术后轻度不良反应2例,无并发症发生。结论经皮臭氧注射治疗椎间盘突出合并腰椎管狭窄症疗效肯定,远期效果理想,安全可靠,值得推广。

Objective To study the clinical effects of oxygen-ozone therapy in the treatment of patients with lumbar disc herniation complicated with lumbar spinal stenosis. Methods Forty-six patients with lumbar disc hernia- tion complicated with lumbar spinal stenosis were treated with oxygen-ozone therapy. All the patients were followed up for 6 months. The clinical efficacy was evaluated by modified MacNab method one week, 3 months and 6 months after treatment. The degree of pain was evaluated using Visual Analogue Scale （VAS）. The therapeutic effects at differ- ent time points were compared. Results The significant effective rate and total effective rate were 80.4% （37/46） and 93.5% （43/46） one week after treatment, 76.1% （35/46） and 91.3% （42/46） 3 months after treatment, 76.1% （35/46） and 89.1% （41/46） 6 months after treatment, with no statistically significant difference between the three time points （P〉0.05）. The VAS 3 months after treatment was significantly lower than before treatment （P〈0.01）, and the VAS 6 months after treatment was significantly lower than that 3 months after treatment （P〈0.01）. There were 2 cases with adverse reactions, but no complications occurred. Conclusion Oxygen-ozone therapy has a positive effect in patients with lumbar disc herniation combined with lumbar spinal stenosis, with ideal long-term effects, which is safe, reli- able, and worthy of promotion.