超声引导与C臂引导下水针刀疗法治疗腰椎间盘突出症临床效果对比研究

Comparative Study on Clinical Effect of Liquid Acupotomy Therapy Guided by Ultrasound and by C-Arm in Treatment of Lumbar Disc Herniation

目的:观察比较超声引导下水针刀疗法与C臂引导下水针刀疗法治疗腰椎间盘突出症的临床疗效及安全性。方法:将纳入的腰椎间盘突出症患者分为2组,观察组20例在超声引导下行水针刀疗法,对照组19例在C臂引导下行水针刀疗法,2组均口服药物甲钴胺片2周,2周后随访1个月。于治疗前、术后1 d及随访1个月应用国际Oswestry功能障碍指数(ODI)对腰椎功能进行评定,以视觉模拟评分法(VAS)评定疼痛程度,记录水针刀治疗过程中的操作时间及穿刺次数。结果:治疗后,2组VAS评分、ODI评分均呈下降趋势(P<0.05),2组术后1 d、随访1个月的2项评分均低于治疗前,差异均有统计学意义(P<0.05);2组随访1个月的2项评分与术后1 d比较,差异均有统计学意义(P<0.05)。2组VAS评分、ODI评分比较,差异均无统计学意义(P>0.05)。观察组穿刺次数少于对照组,操作时间短于对照组,差异均有统计学意义(P<0.05)。结论:与C臂引导相比,在超声引导下行水针刀治疗,可减少穿刺次数及手术时间,有效避免损伤神经及神经周围的血管,同时也减少了医务人员及患者的辐射暴露。

Objective:To observe and compare the clinical effect and safety of liquid acupotomy therapy guided by ultrasound and by C-arm in the treatment of lumbar disc herniation.Methods:The enrolled patients with lumbar disc herniation were divided into the observation group and the control group,20 and 19 cases in each group respectively.The observation group was treated with liquid acupotomy therapy guided by ultrasound,and the control group was treated with liquid acupotomy therapy guided by C-arm.Both groups were given two-week oral administration of mecobalamin tablets.After medicine treatment,the follow-up lasted for one month.Before surgery as well as on the 1 stday after surgery and after follow up for one month,Oswestry dysfunction index(ODI)was used to evaluate the lumbar vertebra function;Visual Analogue Scale(VAS)was used to evaluate the pain degree;duration of operation and frequency of puncture were recorded during the period of liquid acupotomy therapy.Results:After surgery,scores of VAS and ODI in the two groups showed a downtrend,and the two scores on the 1 stday after surgery and after follow up for one month were lower than those before surgery,differences being significant(P<0.05);in the two groups,the comparison of the two scores and after follow up for one month with those on the 1 stday after surgery also showed significance in differences(P<0.05).No significant differences were found in the comparison of scores of VAS and ODI between the two groups(P>0.05).The times of puncture in the observation group was less than that in the control group,and the operation time was shorter,differences being significant(P<0.05).Conclusion:In comparison with liquid acupotomy therapy guided by C-arm,liquid acupotomy therapy guided by ultrasound can lower frequency of puncture,shorten duration of operation,effectively avoid injury of nerve and blood vessel around it,and meanwhile relieve the effect of radiation exposure on medical staff and patients.