针刀联合CT引导下低温等离子多靶点射频消融治疗颈、腰椎间盘突出症的临床效果

Clinical effect of acupuncture combined with CT-guided low-temperature plasma multi-target radiofrequency ablation in patients with cervical and lumbar intervertebral disc herniation

目的探讨针刀联合CT引导下低温等离子多靶点射频消融在颈、腰椎间盘突出症患者中的临床效果。方法选取2019年1月至2020年12月赣州市人民医院疼痛科收治的86例颈、腰椎间盘突出症患者作为研究对象,采用随机数字表法分为对照组(43例)和观察组(43例)。对照组患者采用针刀治疗,观察组患者联合CT引导下低温等离子多靶点射频消融治疗,比较两组患者视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)、下肢神经功能、并发症及复发率。结果观察组治疗4周后VAS、ODI评分低于对照组,差异有统计学意义(P<0.05);观察组治疗4周后腓总神经、胫神经运动传导速度及腓浅神经和腓肠神经感觉传导速度高于对照组,差异有统计学意义(P<0.05)。两组患者治疗期间创面粘连、切口感染及下肢放射性疼痛发生率比较,差异无统计学意义(P>0.05)。观察组随访12个月复发率低于对照组,差异有统计学意义(P<0.05)。结论针刀联合CT引导下低温等离子多靶点射频消融用于颈、腰椎间盘突出症患者中,有助于减轻患者疼痛及功能障碍,改善下肢神经功能,且安全性较高,能降低远期复发率,值得推广应用。

Objective To investigate the clinical effect of acupuncture combined with CT-guided low-temperature plasma multi-target radiofrequency ablation in patients with cervical and lumbar intervertebral disc herniation.Methods A total of 86 patients with cervical and lumbar intervertebral disc herniation admitted to the Department of Pain of Ganzhou People's Hospital from January 2019 to December 2020 were selected as the research objects,they were divided into the control group(43 cases)and the observation group(43 cases)according to random number table method.The patients in the control group were treated with acupuncture,and the patients in the observation group were combined with CT-guided low-temperature plasma multi-target radiofrequency ablation.The visual analogue scale(VAS),Oswestry disability index(ODI),lower extremity neurological function,complications and recurrence were compared between the two groups.Results The VAS and ODI scores of the observation group were lower than those of the control group after 4 weeks of treatment,and the differences were statistically significant(P<0.05).The motor conduction velocity of common peroneal nerve,tibial nerve and sensory conduction velocity of superficial peroneal nerve and sural nerve of the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The differences of incidences of wound adhesion,incision infection and lower extremity radiation pain in the two groups were not statistically significant(P>0.05).The 12-month follow-up recurrence rate in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Acupuncture combined with CT-guided low-temperature plasma multi-target radiofrequency ablation in patients with cervical and lumbar intervertebral disc herniation can help reduce the pain and dysfunction of the patients,improve the nerve function of the lower extremity,has high safety,and can reduce the long-term recurrence rate,it is worthy of promotion and application.