臭氧消融联合射频热凝治疗腰椎间盘突出症临床研究

Therapeutic effect of ozone ablation combined with radiofrequency thermocoagulation on the treatment of lumbar disc herniation

目的:比较臭氧消融联合射频热凝与单纯臭氧消融治疗腰椎间盘突出症的临床效果。方法:将80例腰椎间盘突出症患者随机2组,每组40例。治疗组采用臭氧消融联合射频热凝治疗,对照组采用单纯臭氧消融治疗。治疗后采用MacNab法评定2组患者的临床疗效,并测定2组患者腓总神经和胫后神经肌电图F波传导速度。结果:①临床疗效。治疗组显效29例、有效9例、无效2例,对照组显效13例、有效22例、无效5例,治疗组临床疗效优于对照组(u=1 299.500,P=0.001)。②肌电图F波传导速度。治疗前2组患者腓总神经和胫后神经肌电图F波传导速度比较,差异均无统计学意义[(21.725±3.218)m·s-1,(21.475±3.178)m·s-1,t=0.316,P=0.753;(19.950±2.900)m·s-1,(19.750±3.028)m·s-1,t=1.818,P=0.077],治疗后治疗组腓总神经和胫后神经肌电图F波传导速度均高于对照组[(48.900±4.733)m·s-1,(39.000±4.669)m·s-1,t=106.030,P=0.000;(44.200±2.928)m·s-1,(34.025±2.885)m·s-1,t=60.741,P=0.000]。结论:臭氧消融联合射频热凝可有效缓解腰椎间盘突出症患者的临床症状,改善下肢神经功能,疗效优于单纯臭氧消融治疗。

Objective：To compare the clinical effects of ozone ablation combined with radiofrequency thermocoagulation versus ozone ablation on the treatment of lumbar disc herniation（LDH）. Methods：Eighty patients with LDH were randomly divided into treatment group and control group ,40 cases in each group. Patients in treatment group were treated with Ozone ablation combined with radiofrequency ther- mocoagulation, while the others in control group were treated with Ozone ablation only. The curative effects were evaluated according to as- sessed MacNab, and F-wave conduction velocity of＂ electromyography（EMG） on peroneal nerve and posterior tibia/nerve were measured in the 2 groups after the treatment. Results：Twenty-nine patients obtained an excellent clinical curative effects,9 good, and 2 poor in the treat- ment group,while 13 patients obtained an excellent clinical curative effects ,22 good, and 5 poor in the control group. The treatment group surpassed the control group in the total curative effect（ u = 1 299. 500 ,P = 0. 001 ）. There was no statistical difference in the F-wave con- duction velocity of EMG on peroneal nerve and posterior tibial nerve between the 2 groups before the treatment （ 21. 725 ＋/- 3. 218 vs 21.475 ＋/-3. 178 rn/s,t =0. 316,P =0. 753;19. 950 ＋/-2. 900 m/s vs 19.750 ＋/-3.028 m/s,t = 1. 818,P =0. 077） ,and the F-wave conduction velocity of EMG on peroneal nerve and posterior tibial nerve in treatment group were higher than that of the control group （48. 900 ＋/- 4. 733 vs 39. 000 ＋/- 4. 669 m/s, t = 106. 030, P = 0. 000 ;44. 200 ＋/- 2. 928 vs 34. 025 ＋/- 2. 885 m/s, t = 60. 741, P = 0. 000）. Conclusion ：The therapy of Ozone ablation combined with radiofrequency thermocoagulation can effectively relieve the clinical symptoms in patients with LDH, and improve the nerve function of lower limb, and its curative effect is better than that of ozone ablation.