目的 观察CT引导下射频热凝联合臭氧消融术治疗腰椎间盘突出症(LDH)的临床疗效及安全性.方法 选取80例LDH患者,随机分臭氧组(40例)和联合组(40例),臭氧组给予单纯的臭氧溶核术,联合组先行射频热凝治疗,后行椎间盘内、盘外臭氧溶核术.采用视觉模拟疼痛评分(VAS)作为疼痛水平评价指标,改良Macnab标准评估治疗效果.观察术后1、3、6、12个月VAS评分及术后12个月总有效率.结果 2组术后1、3、6、12个月腰腿痛VAS评分显著低于治疗前(P均＜0.01);且联合组VAS评分显著低于臭氧组(P＜0.05或P＜0.01).术后12个月联合组的总有效率(91.9%)显著高于臭氧组(74.3%),差异有统计学意义(P＜0.05).2组患者均无过敏反应、椎间隙感染或脊髓、神经、血管及腹腔脏器损伤等严重并发症.结论 CT引导下靶点射频热凝加臭氧消融术治疗LDH安全、微创,较单纯臭氧消融术疗效更好,恢复更快.%Objective To observe the effects and safety of CT-guided radiofrequency thennocoagulation combined with ozone nucleus pulposus ablation in treatment of lumbar disc hemiation. Methods Eighty cases with lumbar disc hemia-tion were randomly divided into ozone treatment group ( 40 cases ) and combination treatment group ( 40 cases ). The cases in the ozone group were treated with ozone nucleus pulposus ablation therapy alone, another 40 cases in the combination group were treated with ozone nucleus pulposus ablation therapy at once after radiofrequency thermocoagulation. Therapeutic effects were evaluated at the time points of 1 month, 3 months,6 months and 12 months after surgery by using the average scores of VAS and Macnabs standard. Results The average scores of VAS at the time points of 1 month,3 months,6 months and 12 months after surgery in both groups were significantly lower than before treatment ( all P < 0. 01 ), and it was more obviously in the combination treatment group than that in the ozone treatment group ( P < 0. 05 or P < 0. 01 ). The total efficiency within 12 months after surgery in the combination treatment group ( 91. 9% ) were higher than that in the ozone treatment group ( 74. 3% , P <0. 05 ). There were no allergic reactions, disc space infection or spinal cord, nerves, blood vessels and abdominal organ injuries and other serious complications in both two groups. Conclusion CT-guided radiofrequency thermocoagulation combined with ozone nucleus pulposus ablation was safe and minimally invasive, which was superior to that of using ozone nucleus pulposus ablation alone.
展开▼
