CT引导下射频消融联合臭氧治疗腰椎间盘突出症患者效果观察

Efficacy of radiofrequency ablation combined with ozone therapy under CT guidance in the treatment of lumbar disc herniation

目的探讨CT引导下射频消融联合臭氧治疗腰椎间盘突出症(lumbar disc herniation,LDH)患者的效果。方法选取宁波市康复医院及嘉兴市第一医院2019年1月至2022年5月收治的LDH患者93例为观察对象,采用随机数字表法分观察组(47例)与对照组(46例)。对照组行射频消融术治疗,观察组在射频消融术基础上联合臭氧治疗。比较两组术后3个月疗效;术前、术后7 d和术后3个月疼痛情况;术前和术后7 d炎性因子水平变化;术前和术后3个月腰椎功能。结果观察组术后3个月优良率[89.36%(42/47)]显著高于对照组[71.74%(33/47)](χ^(2)=4.63,P<0.05)。观察组视觉模拟评分法(VAS)评分术后7 d[(2.91±0.54)分]和术后3个月[(1.32±0.31)分]均显著低于对照组[(3.76±0.62)分、(2.08±0.47)分](t=7.06、9.22,均P<0.001)。观察组术后7 d血清白细胞介素1β(IL-1β)[(0.24±0.05)μg/L]、IL-6[(18.49±3.47)ng/L]和肿瘤坏死因子α(TNF-α)[(97.94±17.43)ng/L]水平均显著低于对照组[(0.37±0.09)μg/L、(24.31±4.12)ng/L和(148.87±20.13)ng/L](t=8.63、7.37、13.05,均P<0.001)。观察组术后3个月日本骨科协会(JOA)评分[(25.68±2.28)分]显著高于对照组[(21.17±3.24)分],而Oswestry功能障碍指数(ODI)评分[(9.84±1.43)分]显著低于对照组[(13.46±2.18)分](t=-7.78、9.49,均P<0.001)。结论CT引导下射频消融联合臭氧治疗LDH效果显著,可减轻患者疼痛、炎性反应,并改善患者腰椎功能。

Objective To investigate the efficacy of radiofrequency ablation combined with ozone therapy under CT guidance in the treatment of lumbar disc herniation.Methods A total of 93 patients with lumbar disc herniation who were admitted to The First Hospital of Jiaxing from January 2019 to May 2022 were included in this study.They were randomly divided into an observation group(n=47)and a control group(n=46).The control group was treated with radiofrequency ablation and the observation group was treated with radiofrequency ablation combined with ozone therapy.Efficacy was compared between the two groups at 3 months after surgery.The pain was compared between the two groups before and 7 days and 3 months after surgery.Inflammatory factors were compared between the two groups before and 7 days after surgery.The lumbar spine function was compared between the two groups before and 3 months after surgery.Results At 3 months after surgery,the excellent and good rate in the observation group was significantly higher than that in the control group[89.36%(42/47)vs.71.74%(33/47),χ^(2)=4.63,P<0.05).At 7 days and 3 months after surgery,Visual Analogue Scale scores in the observation group were(2.91±0.54)points and(1.32±0.31)points,respectively,which were significantly lower than(3.76±0.62)points and(2.08±0.47)points in the control group(t=7.06,9.22,both P<0.001).At 7 days after surgery,serum interleukin-1β,interleukin-6,and tumor necrosis factor-αin the observation group were(0.24±0.05)μg/L,(18.49±3.47)ng/L,and(97.94±17.43)ng/L,respectively,which were significantly lower than(0.37±0.09)μg/L,(24.31±4.12)ng/L,and(148.87±20.13)ng/L,respectively in the control group(t=8.63,7.37,13.05,all P<0.05).At 3 months after surgery,the Japanese Orthopedic Association score in the observation group was significantly higher than that in the control group[(25.68±2.28)points vs.(21.17±3.24)points,t=-7.78,P<0.001],and the Oswestry Disability Index in the observation group was significantly lower than that in the control group[(9.84±1.43)points vs.(13.46±2.18)points,t=9.49,P<0.001].Conclusion Radiofrequency ablation combined with ozone therapy under CT guidance is highly effective on lumbar disc herniation.The combined therapy can reduce pain and inflammatory reactions in patients and improve lumbar function.