低温等离子射频消融联合臭氧注射治疗颈椎间盘突出症疗效观察

Efficacy of temperature-controlled plasma radiofrequency ablation combined with ozone injection in the treatment of cervical disc herniation

目的探讨低温等离子射频消融联合臭氧注射治疗颈椎间盘突出症的临床疗效。方法选取兰州市妇幼保健院2014年1月至2016年12月期间收治的60例颈椎间盘突出症患者,按照随机数表法分为观察组和对照组,每组30例。观察组应用低温等离子射频消融联合臭氧注射髓核消融术治疗,对照组应用低温等离子射频消融术治疗。观察两组患者治疗前、治疗后1周、1个月、3个月视觉模拟疼痛评分(VAS)、Oswestry功能障碍评分(ODI)、患处椎间隙高度及临床疗效。结果治疗前观察组、对照组患者VAS评分[(8.24±1.04)分vs(8.38±1.06)分]和ODI评分[(32.26±6.75)分vs(34.36±6.88)分]比较差异均无统计学意义(P>0.05);治疗后1周、1个月、3个月,观察组患者VAS评分分别为(2.37±1.07)分、(1.75±1.08)分、(0.93±1.01)分,对照组分别为(2.95±1.08)分、(2.54±1.10)分、(1.72±1.08)分;观察组患者ODI评分分别为(15.25±3.65)分、(11.36±4.08)分、(8.22±2.54)分,对照组分别为(24.66±4.65)分、(23.75±6.54)分、(18.68±5.23)分,两组患者VAS评分、ODI评分均较治疗前降低,观察组患者VAS评分、ODI评分明显低于对照组,差异均有统计学意义(P<0.05);治疗前、治疗后1周、1个月、3个月,观察组、对照组患者椎间隙高度[(0.21±0.03)mm vs(0.22±0.02)mm,(0.21±0.02)mm vs(0.22±0.03)mm,(0.21±0.02)mm vs(0.21±0.03)mm,(0.22±0.02)mm vs(0.22±0.03)mm]比较差异均无统计学意义(P>0.05);观察组患者的治疗总优良率为96.67%,明显高于对照组的80.00%,差异有统计学意义(P<0.05)。结论低温等离子射频消融联合臭氧注射治疗颈椎间盘突出症可以有效缓解患者症状和疼痛,改善患者颈椎功能,其治疗效果优于低温等离子射频消融治疗。

Objective To investigate the clinical efficacy of temperature-controlled plasma radiofrequency ab-lation combined with ozone injection in the treatment of cervical disc herniation. Methods Sixty patients with cervicaldisc herniation who treated in our hospital from January 2014 to December 2016 were selected, which were divided intoobservation group and control group according to the random number table, with 30 cases in each group. The observa-tion group was treated with temperature-controlled plasma radiofrequency ablation combined with ozone injection nucle-us ablation, while control group was treated with temperature-controlled plasma radiofrequency ablation. The visual ana logue pain score （VAS）, Oswestry dability index （ODI）, height of the intervertebral space and the clinical efficacy of the two groups were observed before treatment, 1 week, 1 month and 3 months after treatment. Results There was no sig- nificant difference between the observation group and control group in VAS scores （8.24± 1.04） vs （8.38±1.06） and ODI scores （32.26±6.75） vs （34.36±6.88） before treatment （P〉0.05）. At 1 week, 1 month and 3 months after treatment, the VAS scores of observation group were （2.37±1.07）, （1.75±1.08）, （0.93±1.01） respectively, and the VAS scores of control group were （2.95±1.08）, （2.54± 1.10）, （1.72±1.08）; The ODI scores of observation group were （15.25±3.65）, （11.36±4.08）, （8.22±2.54）, and the ODI scores of control group were （24.66±4.65）, （23.75±6.54）, （18.68±5.23）. The VAS scores and ODI scores after treatment in the two groups were decreased than those before treatment, and the VAS scores and ODI scores of observation group were lower than those of control group （P〈0.05）. There was no significant difference between the observation group and control group in disc height before treatment, 1 week, 1 month and 3 months after treatment： （0.21±0.03） mm vs （0.22±0.02） mm, （0.21±0.02） mm vs （0.22±0.03） mm,（0.21±0.02） mm vs （0.21±0.03） mm, （0.22±0.02） mm vs （0.22±0.03） mm, P〉0.05. The excellent and good rate of observation group was 96.67%, which was significantly higher than 80.00% of the control group （P〈0.05）. Conclusion Temperature-controlled plasma radio- frequency ablation combined with ozone injection can effectively alleviate the symptoms and pain of patients with cervi- cal disc herniation, which can improve cervical function of patients, and its therapeutic effect is better than that of tem- perature-controlled plasma radiofequency ablation.