经皮介入射频热凝靶点消融术联合神经阻滞治疗椎间盘突出150例临床观察

Clinical observation of percutaneous interventional radiofrequency thermocoagulation target ablation combined with nerve block in the treatment of 150 cases of intervertebral disc herniation

目的 探讨经皮介入射频热凝靶点消融术联合神经阻滞治疗腰椎间盘突出的疗效,为临床应用提供参考。方法 随机抽取2015年5月-2017年5月收治的腰椎间盘突出患者150例,按所采取的不同治疗方法分为观察组和对照组。其中观察组78例,接受经皮介入射频热凝靶点消融术联合神经阻滞治疗;对照组72例,单纯接受神经阻滞治疗。采用Osw estry腰椎功能障碍指数（ODI）评价治疗前后2组患者腰椎功能障碍程度,采用改良MacNab评分评价2组患者的疗效,观察2组患者治疗期间不良反应的发生情况。结果 治疗前2组ODI评分比较差异无统计学意义,经治疗4周后2组ODI均较治疗前明显降低（P〈0.05）,观察组ODI显著低于对照组（P〈0.05）。经治疗后观察组有效率为96.15%（75/78）,优良率为91.03%（71/78）;对照组有效率为90.28%（65/72）,优良率为65.28%（47/72）。观察组治疗有效率高于对照组,但比较差异无统计学意义,优良率显著高于对照组（P〈0.05）。2组治疗过程中均未发生明显不良反应。结论 经皮介入射频热凝靶点消融术联合神经阻滞治疗腰椎间盘突出疗效显著,安全性高。

Objective To explore the effect of percutaneous interventional radiofrequency thermocoagulation target ablation combined with nerve block in the treatment of lumbar disc herniation, and to provide reference for clinical application. Methods Randomly selected from May 2015 to May 2017 treatment of lumbar disc herniation in 150 cases, according to the different treatment methods were divided into observation group and control group. The observation group of 78 cases, including percutaneous interventional radiofrequency thermocoagulation target ablation combined with nerve block treatment; the control group of 72 cases, simply accept the nerve block treatment. The degree of lumbar dysfunction was evaluated by Osw estry Lumbar Dysfunction Index （ODI） before and after treatment. The efficacy of the two groups was evaluated by modified MacNab score. Adverse reactions were observed during the two groups. Results There was no significant difference between the two groups. After 2 weeks of treatment, the scores of ODI were significantly lower than those before treatment （P〈0.05）. The ODI score of the observation group was significantly lower than that of the control group （P〈0.05）. The effective rate was 96.2% （75/78） and the excellent and good rate was 91.03% （71/78）. The effective rate was 90.28% （65/72） and the excellent and good rate was 65.28% （47/72）. The excellent and good rate of the observation group was significantly higher than that of the control group （P〈0.05）. There were no significant adverse reactions in the two groups. Conclusion Percutaneous interventional radiofrequency thermocoagulation target ablation combined with nerve block treatment of lumbar disc herniation significantly, high safety.