首页|脊神经靶点脉冲射频联合脊神经后支射频热凝治疗腰椎间盘突出症的临床研究

脊神经靶点脉冲射频联合脊神经后支射频热凝治疗腰椎间盘突出症的临床研究

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目的:探讨脊神经靶点脉冲射频联合脊神经后支射频热凝治疗腰椎间盘突出症(LDH)的临床疗效。方法:采用随机数字表法将2022年1月至2023年6月收治住院的100例腰椎间盘突出症患者随机分为观察组(50例，脊神经靶点脉冲射频联合脊神经后支射频热凝组)和对照组(50例，脊神经靶点脉冲射频组)，两组患者均治疗后随访3个月，以射频治疗前和治疗后3 d、1周、1个月及3个月的视觉模拟量表(VAS)评分、Oswestry功能指数(ODI)、日本骨科协会(JOA)评分、改良MacNab疗效评价及治疗后1周的远红外热像参数作为疗效评定标准。结果:术后3 d及1周时，观察组患者VAS评分均明显低于对照组，差异有统计学意义(P＜0。05);ODI评分及JOA评分均明显优于对照组，差异有统计学意义(P＜0。05);术后1个月及3个月两组患者的VAS评分、ODI评分及JOA评分逐渐趋近相同，差异无统计学意义(P＞0。05);术后3个月MacNab疗效评价显示观察组患者的总有效率(96％)显著高于对照组(88％)，差异有统计学意义(P＜0。05);术后1周观察组患者腰背部温度改善明显优于对照组，差异有统计学意义(P＜0。05)。结论:数字减影血管造影(DSA)机引导下脊神经靶点脉冲射频联合脊神经后支射频热凝治疗腰椎间盘突出症效果显著，可以明显改善腰椎间盘突出症患者早期腰部及下肢的疼痛麻木症状，提高患者日常生活质量，具有较好的临床应用价值。
Clinical Atudy of Spinal Nerve Target Pulse Radiofrequency Combined with Posterior Branch Radiofrequency Thermocoagulation for the Treatment of Lumbar Disc Herniation
Objective:To explore the clinical efficacy of spinal nerve target pulse radiofrequency combined with posterior branch radiofrequency thermocoagulation on the treatment of lumbar disc herniation(LDH).Methods:100 LDH patients from January 2022 to June 2023 were randomly divided into observation group(50 cases,spinal nerve target pulsed radio-frequency combined with spinal nerve posterior branch radiofrequency thermocoagulation group)and control group(50 cases,spinal nerve target pulsed radiofrequency group).Both groups of patients were followed up for 3 months after treatment,and visual analogue scale(VAS)scores,Oswestry disability index(ODI),Japanese orthopedic association(JOA)scores were measured before and at 3 d,1 week,1 month,and 3 months after radiofrequency treatment,impro-ving the efficacy evaluation of MacNab and using far-infrared thermal imaging parameters 1 week after treatment as the evaluation criteria for efficacy.Results:The VAS scores of the observation group were significantly lower than those of the control group at 3 d and 1 week after surgery,with signif-icant differences(P＜0.05).The ODI and JOA scores were significantly better than those of the control group,with sig-nificant differences(P＜0.05).The VAS scores,ODI scores,and JOA scores of the two groups gradually approached the same level at 1 month and 3 months after surgery,and the difference was not statistically significant(P＞0.05).The Mac-Nab efficacy evaluation at 3 months after surgery showed that the total effective rate of the observation group(96％)was significantly higher than that of the control group(88％)(P＜0.05).The observation group showed a significant improvement in lower back temperature compared to the control group 1 week after surgery,with a statistical difference(P＜0.05).Conclusion:Digital subtraction angiography(DSA)guided radiofrequency modulation of spinal nerve target pulse combined with radiofrequency thermocoagulation of posterior branch of spinal nerve has a significant efficacy on the treatment of lumbar disc herniationwith Qi stagnation and blood stasis,which can effectively relieve the pain symptoms of patients'waist and lower limbs in the early stage,improve the quality of life of patients,and has good clinical application value.

lumbar disc herniationpulse radiofrequencyposterior branch of spinal nerveinfrared thermographyradio-frequency thermocoagulation

王俊龙、刘爱峰、张超、李远栋、王平、周鑫、张晓宇、崔庆同、张良

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天津中医药大学第一附属医院国家中医药管理局区域中医骨伤科诊疗中心,国家中医针灸临床医学研究中心(天津,300381)

腰椎间盘突出症 脉冲射频 脊神经后支 红外热像 射频热凝

天津中医药大学第一附属医院"拓新工程"基金科研课题国家自然科学基金国家自然科学基金国家自然科学基金

院YB202120823744898187331681673994

2024

10.20085/j.cnki.issn1005-0205.240510

中国中医骨伤科杂志
中华中医药学会,湖北省中医药研究院

中国中医骨伤科杂志

CSTPCD
影响因子：0.732
ISSN：1005-0205
年,卷(期)：2024.32(5)
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