臭氧联合椎间孔神经阻滞治疗椎间孔镜术后腰腿痛的疗效观察

Transforaminal ozone and nerve root block for treatment of lumbocrural pain after percutaneous transforaminal endoscopic discectomy

目的探讨臭氧责任椎间孔注射联合椎责任间孔神经阻滞治疗椎间孔镜术后腰腿痛的临床疗效。方法收集2017年3月至2020年3月于解放军总医院第六医学中心中医医学部骨伤科住院行腰椎间孔镜术后出现腰腿痛患者80例,分为两组各40例,神经阻滞组给予单纯神经阻滞治疗,联合臭氧组给予臭氧联合神经阻滞治疗。分别于治疗前及治疗后1 d、1个月、3个月时记录疼痛视觉模拟评分(VAS),评定患者不同时点的临床症状改善情况。结果全组患者均顺利完成治疗,随访期间未见严重不良反应及并发症。两组患者治疗后各时点的VAS评分均较治疗前明显改善,差异有统计学意义(P<0.01);治疗后1 d两组患者VAS评分差异无统计学意义(P>0.05);治疗后1个月及3个月,联合臭氧组患者的VAS评分优于神经阻滞组,差异均具有统计学意义(P均<0.05)。治疗后6个月时采用改良MacNab标准评价疗效,神经阻滞组优良率为72.5%(29/40例),联合臭氧组为90.0%(36/40例),两组比较差异具有统计学意义(P<0.05)。结论椎间孔臭氧联合神经阻滞疗法可有效改善椎间孔镜术后腰腿痛症状且疗效较持久,可提高患者生活质量。

Objective To observe the clinical effect of ozone combined with nerve root block transforaminal injection for the treatment of lumbocrural pain after percutaneous transforaminal endoscopic discectomy(PTED).Methods Eighty patients with lumbocrural pain after PTED,from March 2017 to March 2020,were collected in the Orthopedics of TCM Clinical Unit,Sixth Medical Center of PLA General Hospital.The patients were divided into two groups,40 cases in each group.The patients received nerve root block in the nerve root block group,and received ozone combined with nerve root block transforaminal injection in the combined ozone group.VAS were assessed before the treatment,and 1 day,1 month,and 3 months after the treatment.Clinical curative effects were evaluated at different time points.Results The VAS decreased significantly after the treatment in all patients(P<0.01),and were obviously better in the combined ozone group than those in the nerve root block group at 1 month and 3 months after the treatment(P<0.05).Six months after the treatment,the excellent and good rate was 72.5%(29/40 cases)in the nerve root block group,and 90.0%(36/40 cases)in the combined ozone group(P<0.05).No serious adverse reactions or complications were found in all patients during the followed up period.Conclusions Transforaminal injection of ozone combined with nerve root block is an effective method for the treatment of lumbocrural pain after PTED.