CT引导下微创三氧消融术联合塞来昔布治疗腰椎间盘突出症的临床价值

Clinical Value of CT-guided Minimally Invasy Trioxy Ablation Combined with Celecoxib in the Treatment of Lumbar Disc Herniation

目的:分析CT引导下微创三氧消融术联合塞来昔布治疗腰椎间盘突出症的临床价值。方法:选取2022年1月—2023年1月厦门市第五医院收治的60例腰椎间盘突出症患者作为研究对象,根据治疗方法不同分为治疗组、对照组,各30例。治疗组采用CT引导下微创三氧消融术联合塞来昔布治疗,对照组采用CT引导下微创三氧消融术治疗。比较两组治疗前后疼痛程度、腰椎功能、实验室指标及不良反应发生率。结果:治疗30 d、3个月、6个月后,治疗组视觉模拟评分法(VAS)评分低于对照组,差异有统计学意义(P<0.05)。治疗6个月后,治疗组改良日本骨科协会腰痛评分表(M-JOA)评分、腰椎功能障碍指数(ODI)评分、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、5-羟色胺(5-HT)、环氧化酶-2(COX-2)、血管内皮生长因子(VEGF)水平均低于对照组,基质金属蛋白酶-9(MMP-9)、磷酸化-P38丝裂原活化蛋白激酶(p-P38MAPK)水平高于对照组,差异有统计学意义(P<0.05)。治疗6个月后,治疗组腰椎疼痛、下肢麻木、活动受限评分低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:CT引导下微创三氧消融术联合塞来昔布治疗腰椎间盘突出症可减轻患者疼痛,改善症状,提高腰椎功能,有利于降低炎症因子和疼痛介质水平,有利于p-P38MAPK通路蛋白的表达,并且治疗安全性较高。

Objective:To analyze the clinical value of CT-guided minimally invasive trioxy ablation combined with Celeoxib in the treatment of lumbar disc herniation.Method:A total of 30 patients with lumbar disc herniation who admitted to Xiamen Fifth Hospital from January 2022 to January 2023 were selected as the study objects,and they were divided into the treatment group and the control group according to different treatment methods,with 30 cases in each group.The treatment group was treated with CT-guided minimally invasive trioxy ablation combined with Celeoxib,the control group was treated with CT-guided minimally invasive trioxy ablation.The pain degree,lumbar function,laboratory indexes before and after treatment and incidence of adverse reactions were compared between two groups.Result:After 30 d,3 months and 6 months of treatment,the visual analogue scale(VAS)scores of the treatment group were lower than those of the control group,and the differences were statistically significant(P<0.05).After 6 months of treatment,the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),5-hydroxyserotonin(5-HT),cyclooxygenase-2(COX-2)and vascular endothelial growth factor(VEGF)in the treatment group were lower than those in the control group,the levels of matrix metalloproteinase-9(MMP-9)and phosphorylated-P38 mitogen-activated protein kinase(p-P38MAPK)were higher than those in control group,and the differences were statistically significant(P<0.05).After 6 months of treatment,the scores of lumbar pain,lower limb numbness and limited movement in the treatment group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion:CT-guided minimally invasive trioxy ablation combined with Celecoxib in patients with lumbar disc herniation can alleviate pain,improve symptoms,improve lumbar spine function,reduce inflammatory factors and pain mediators levels,promote the expression of p-P38MAPK pathway protein,and have high treatment safety.