经皮射频靶点热凝联合臭氧消融对腰椎间盘突出症患者炎性因子及临床疗效的影响
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摘要
目的探讨经皮射频靶点热凝联合臭氧消融对腰椎间盘突出症患者炎性因子及临床疗效的影响,分析其可能作用机制。方法选择2014-01-2015-08收治的126例腰椎间盘突出症患者为研究对象,采用随机数字表法分为观察组和对照组各63例,对照组给予用经皮穿刺射频靶点热凝消融术治疗,观察组采取射频热凝靶点消融术联合臭氧注射治疗。结果随访6个月,观察组有效率93.65%明显高于对照组80.95%(x~2=4.582,P<0.05);术后1周时,观察组血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)含量均明显低于对照组(t=5.506~15.991,P<0.05,P<0.01);手术后6个月,观察组Oswestry功能障碍指数(ODI)评分明显低于对照组,日本矫形外科协会(JOA)评分明显高于对照组(t=7.990,7.829,P<0.05)。结论经皮靶点射频热凝联合臭氧消融治疗有助于缓解腰椎间盘突出患者炎性反应,改善腰部功能,提高临床疗效。
Objective To investigate the effect of percutaneous puncture radiofrequency thermocoagulation and target ablation in combination with ozone ablation technique on inflammatory factors and clinical efficacy of patients with lumbar disc herniation(LDH) and to analyze the possible mechanism. Methods A total of 126 patients with LDH admitted to our hospital from January 2014 to August 2015 were selected and divided into the observation group and control group according to the random number table method, with 63 cases in each group. The control group was performed percutaneous puncture radiofrequency thermocoagulation and target ablation, based on this, patients in the observation group were given ozone ablation. Results After 6 months of follow-up, the effective rate of observation group was 93.65%, which was significantly higher than 80.95% of the control group(x~2=4.582,P <0.05). At 1 week after operation, the levels of serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6) and interleukin-8(IL-8) in observation group were significantly lower than those in the control group(t=5.506~15.991, P<0.05, P<0.01). At 6 months after operation, score of Oswestry disability index(ODI) in observation group was significantly lower than that in control group, and score of Japanese Orthopaedic Association(JOA) was significantly higher than that in the control group(t=7.990, 7.829, P<0.05). Conclusion Percutaneous puncture radiofrequency thermocoagulation and target ablation in combination with ozone ablation technique is conductive to relieving the inflammatory response of patients with LDH, improving the waist function and enhancing the clinical efficacy.
Objective To investigate the effect of percutaneous puncture radiofrequency thermocoagulation and target ablation in combination with ozone ablation technique on inflammatory factors and clinical efficacy of patients with lumbar disc herniation(LDH) and to analyze the possible mechanism. Methods A total of 126 patients with LDH admitted to our hospital from January 2014 to August 2015 were selected and divided into the observation group and control group according to the random number table method, with 63 cases in each group. The control group was performed percutaneous puncture radiofrequency thermocoagulation and target ablation, based on this, patients in the observation group were given ozone ablation. Results After 6 months of follow-up, the effective rate of observation group was 93.65%, which was significantly higher than 80.95% of the control group(x~2=4.582,P <0.05). At 1 week after operation, the levels of serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6) and interleukin-8(IL-8) in observation group were significantly lower than those in the control group(t=5.506~15.991, P<0.05, P<0.01). At 6 months after operation, score of Oswestry disability index(ODI) in observation group was significantly lower than that in control group, and score of Japanese Orthopaedic Association(JOA) was significantly higher than that in the control group(t=7.990, 7.829, P<0.05). Conclusion Percutaneous puncture radiofrequency thermocoagulation and target ablation in combination with ozone ablation technique is conductive to relieving the inflammatory response of patients with LDH, improving the waist function and enhancing the clinical efficacy.
引文
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[6]卢帆,樊宇超,梁琳,等.射频热凝联合臭氧消融治疗腰椎间盘突出症的Meta分析[J].中国疼痛医学杂志,2015,21(6):441-448.
[7]朱峻松,沈玉杰,王宇,等.射频靶点热凝治疗腰椎间盘突出症对外周血中TNF-α和IL-1β的影响[J].中国医药导报,2016,13(30):87-90.
[8]Postacchini F,Postacchini R.Operative management of lumbar disc herniation:the evolution of knowledge and surgical techniques in the last century[J].Acta Neurochir Suppl,2011,108:17-21.
[9]任永生,牟恒志,董振彬,等.CT引导下臭氧联合曲安奈得侧隐窝注射治疗腰椎间盘[J].颈腰痛杂志,2013,34(4):352-353.
[2]张长杰.肌肉骨骼康复学[M].北京:人民卫生出版社,2008:265.
[3]Macnab I.Negative disc exploration:an analysis of the causes of nerve-root involvent in sixty-eight patient[J].J Bone Joint Surg Am,1971,53:891-903.
[4]温优良,李智,梁兴森,等.骶管注射对腰椎间盘突出症大鼠模型神经根局部炎症因子的影响[J].中国骨伤,2014,27(02):153-156.
[5]温优良,李智,邓卫兵,等.骶管注射配合核心肌群稳定性训练治疗老年腰椎间盘突出症的疗效观察[J].中国全科医学,2014,17(18):2132-2135.
[6]卢帆,樊宇超,梁琳,等.射频热凝联合臭氧消融治疗腰椎间盘突出症的Meta分析[J].中国疼痛医学杂志,2015,21(6):441-448.
[7]朱峻松,沈玉杰,王宇,等.射频靶点热凝治疗腰椎间盘突出症对外周血中TNF-α和IL-1β的影响[J].中国医药导报,2016,13(30):87-90.
[8]Postacchini F,Postacchini R.Operative management of lumbar disc herniation:the evolution of knowledge and surgical techniques in the last century[J].Acta Neurochir Suppl,2011,108:17-21.
[9]任永生,牟恒志,董振彬,等.CT引导下臭氧联合曲安奈得侧隐窝注射治疗腰椎间盘[J].颈腰痛杂志,2013,34(4):352-353.