摘要
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±
作者
蒋佩龙
周艳杰
何建国
黄婷
王丽君
黄兵
Jiang Peilong;Zhou Yanjie;He Jianguo;Huang Ting;Wang Lijun;Huang Bing(Department of Pain Management,Ningbo Rehabilitation Hospital,Ningbo 315000,Zhejiang Province,China;Department of Pain Management,Ningbo Medical Center Lihuilli Hospital,Ningbo 315100,Zhejiang Province,China;Department of Pain Management,The First Hospital of Jiaxing,Jiaxing 314000,Zhejiang Province,China)
出处
《中国基层医药》
CAS
2023年第3期326-330,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省医药卫生科技计划(2019ZH046)。
关键词
体层摄影术
X线计算机
影像引导
射频消融术
臭氧
椎间盘移位
疼痛
白细胞介素4
肿瘤坏死因子α
治疗结果
Tomography,X-ray computed
Image-guided
Radiofrequency ablation
Ozone
Intervertebral disc displacement
Pain
Interleukin-4
Tumor necrosis factor-alpha
Treatment outcome
