经皮颈椎间盘射频消融术联合银质针治疗颈性眩晕临床疗效观察

Clinical observation of percutaneous radiofrequency ablation of cervical intervertebral disc combined with silver needle in the treatment of cervical vertigo

目的观察经皮颈椎间盘射频消融术联合银质针治疗颈性眩晕患者的临床疗效。方法选择2019年6月—2021年6月绍兴文理学院附属医院确诊为颈性眩晕患者119例作为研究对象,使用随机数字表法将患者分为A组(射频+银质针组,41例)、B组(射频组,39例)、C组(银质针组,39例)。A组患者用颈椎间盘射频联合银质针治疗,B组患者仅用颈椎间盘射频治疗,C组单用银质针治疗。采用颅彩色多普勒超声(TCD)血流检测3组患者干预前及治疗1周、1个月后、3个月后左侧椎动脉(LVA)、右侧椎动脉(RVA)和基底动脉(BA)收缩期最大血流速度(Vmax),并应用眩晕残障程度评定量表评估患者眩晕程度。结果干预后3组患者椎动脉血流动力学均有所改善,干预3个月后,A组LVA-Vmax为(45.51±4.73)cm/s、RVA-Vmax为(45.48±4.70)cm/s、BA-Vmax为(45.54±4.76)cm/s,高于B组[(43.11±4.82)cm/s、(43.01±4.79)cm/s、(43.62±3.95)cm/s]和C组[(43.06±4.98)cm/s、(43.08±4.81)cm/s、(43.11±3.06)cm/s],差异有统计学意义(均P<0.05)。干预后,3组患者眩晕残障程度评分各项指标均有所降低,干预1个月后3组各项指标水平最低,3组间比较差异有统计学意义(均P<0.05)。结论采用颈椎间盘射频联合银质针治疗颈性眩晕,疗效明显优于单用颈椎间盘射频治疗及银质针治疗。

Objective To investigate the clinical effect of percutaneous radiofrequency ablation of cervical intervertebral disc combined with silver needle for cervical vertigo treatment.Methods A total of 119 patients with cervical vertigo diagnosed in the Pain Clinic of the Affiliated Hospital of Shaoxing University of Arts and Sciences from June 2019 to June 2021 were collected.The patients were randomly divided into group A(RF+silver needle group,n=41),group B(RF group,n=39)and group C(silver needle group,n=39).Patients in group A were treated with cervical intervertebral disc radiofrequency combined with silver needle,patients in group B were treated with cervical intervertebral disc radiofrequency only,and patients in group C were treated with silver needle only.The maximum systolic blood flow velocity(Vmax)of left vertebral artery(LVA),right vertebral artery(RVA)and basilar artery(BA)in the three groups before intervention and 1 week,1 month and 3 months after treatment were measured by cranial colour Doppler ultrasound.The vertigo disability rating scale was used in evaluating the degree of vertigo.Results After the intervention,the vertebral artery haemodynamics of the three groups improved.After 3 months of intervention,the LVA-Vmax[(45.51±4.73)cm/s],RVA-Vmax[(45.48±4.70)cm/s],BA-Vmax[(45.54±4.76)cm/s]of group A were higher than those of group B[LVA-Vmax,(43.11±4.82)cm/s;RVA-Vmax,(43.01±4.79)cm/s;BA-Vmax,(43.62±3.95)cm/s]and group C[LVA-Vmax,(43.06±4.98)cm/s;RVA-Vmax,(43.08±4.81)cm/s;BA-Vmax,(43.11±3.06)cm/s],the differences were statistically significant(all P<0.05).After the intervention,all the indicators of the vertigo and disability scores of the three groups decreased,and the three groups had the lowest levels of the indicators after 1 month of intervention,and the differences were statistically significant(all P<0.05).Conclusion The curative effect of cervical disc radiofrequency combined with silver needle in the treatment of cervical vertigo is significantly better than that of cervical disc radiofrequency therapy and silver needle alone.