双极射频靶点热凝联合臭氧消融术治疗腰椎间盘突出症的临床疗效观察

Clinical observation of bipolar radiofrequency target thermal coagulation combined with ozone ablation in the treatment of lumbar intervertebral disc protrusion

[目的]探讨双极射频靶点热凝联合臭氧消融术治疗腰椎间盘突出症的临床疗效。[方法]将64例腰椎间盘突出症患者,随机分为双极射频靶点热凝联合臭氧消融术治疗组和叶氏十步正骨治疗对照组,治疗组与对照组各32例。收集两组治疗前后视觉模拟评分法(VAS)评分、日本骨科协会腰椎功能评价表(JOA)评分、双臀区温差值、双下肢相应部位温差值(ΔT),并使用改良Mac Nab标准进行评估。使用SPSS19.0进行统计分析。[结果]双极射频靶点热凝联合臭氧消融术与手法治疗腰椎间盘突出症均能改善患者疼痛及腰椎功能,治疗3 d后、14 d后、3个月后治疗组疼痛及腰椎功能改善均优于对照组(P<0.05);治疗后3个月,两组患者在臀区、小腿外侧区、小腿后侧区温差均降低,与治疗前对比,差异均有统计学意义(P<0.05);且治疗3个月后,两组患者仅小腿外侧区、小腿后侧区温差各组间对比,差异具有统计学意义(P<0.05);治疗3个月后,治疗组优良率优于对照组,但差异无统计学意义(P>0.05)。[结论]双极射频靶点热凝联合臭氧治疗腰椎间盘突出症在改善患者疼痛及腰椎功能方面疗效确切,且近期疗效稳定,远期疗效仍需进一步观察。

[Objective]To investigate the clinical efficacy of bipolar radiofrequency target thermal coagulation combined with ozone ablation in the treatment of lumbar intervertebral disc protrusion.[Methods]The 64 cases of patients with lumbar intervertebral disc protrusion were randomly divided into two groups:Bipolar radiofrequency target thermal coagulation combined with ozone ablation group and Yip’s ten-step orthopedic treatment group.There are 32 cases treatment group and 32 cases in the control grou.The VAS score,JOA score,and the temperature difference(ΔT)of the two sides of regiones glutaea and lower extremities were collected before and after treatment.The improved MacNab criteria were used for evaluation.Statistical analysis was performed using SPSS 19.0.[Results]Bipolar radiofrequency target thermal coagulation combined with ozone ablation and manipulation of lumbar intervertebral disc protrusion can improve patient painand lumbar function,after treatment for 3 days,14 days later,after 3 months,the pain and lumbar function improvement in the treatment group were better than those in the control group(P<0.05).The 3 months after treatment,the two groups of patients in the of the temperature difference were reduced,compared with before treatment,the difference was statistically significant(P<0.05).And after 3 months of treatment,the difference between the two groups of patients in the regiones cruris posterior and lateralis was significantly(P<0.05).After 3 months of treatment,the excellent rate of the treatment group was better than that of the control group,the difference was no significant(P>0.05).[Conclusion]Bipolar radioactive target thermal coagulation combined with ozone treatment of lumbar intervertebral disc protrusion,in improving patient pain and lumbar function of the exact effect,and the recent efficacy of stability,long-term efficacy remains to be further observed.