臭氧髓核溶解术治疗腰椎间盘突出症的临床分析

Clinical analysis of ozone nucleolysis in the treatment of lumbar disc herniation

摘要:

目的 分析臭氧髓核溶解术对腰椎间盘突出症（lumbar disc herniation，LDH）的疗效。方法 回顾分析2007年9月至2018年9月在本院疼痛科经CT或MRI检查确诊为腰椎间盘突出症患者335例，以腰背部疼痛及下肢麻痛为主要临床表现。其中146例患者采用保守治疗（A组），189例患者采用臭氧髓核溶解术（B组）。分别在治疗前后采用目测类比评分法（Visual Analogue Scale，VAS）作为评估疼痛程度指标，日本骨科协会评估治疗分数(Japanese Orthopaedic Association Scores,JOA)作为评估治疗效果指标。结果 除了A组患者治疗后1天VAS评分没有显著变化之外，两组患者治疗后各时间点VAS评分均有降低，差异有统计学意义（P＜0.05），其中B组患者较A组患者明显降低（P＜0.05）。6个月后B组患者腰椎JOA评分明显高于A组患者，差异有统计学意义（P＜0.05）；6个月后B组患者腰椎JOA评分改善率明显高于A组患者，差异有统计学意义（P＜0.05）。结论 臭氧髓核溶解术是治疗腰椎间盘突出症有效的方法之一，具有安全性高、创伤小、操作简便等特点，值得临床推广应用。

Abstract:

objective：To analyze the effect of ozone nucleolysis on lumbar disc herniation (LDH).Methods：A retrospective analysis was made of 335 cases of lumbar disc herniation diagnosed by CT or MRI from September 2007 to September 2018 in the pain department of our hospital. The main clinical manifestations were low back pain and lower limb pain. One hundred and forty-six patients were treated conservatively (group A), and 189 patients were treated with ozone nucleolysis (group B).Visual Analogue Scale (VAS) was used to evaluate the degree of pain before and after treatment, and Japanese Orthopaedic Association Scores (JOA) was used to evaluate the therapeutic effect.Results：In addition to the VAS score of group A did not change significantly one day after treatment, the VAS score of the two groups decreased at each time point after treatment (P < 0.05), and the VAS score of group B was significantly lower than that of group A (P < 0.05). The JOA score of lumbar spine in group B was significantly higher than that in group A after 6 months (P < 0.05), and the improvement rate of JOA score of lumbar spine in group B was significantly higher than that in group A after 6 months (P < 0.05).Conclusion：Ozone nucleolysis is one of the effective methods for the treatment of lumbar intervertebral disc herniation. It has the characteristics of high safety, small trauma and simple operation, and is worthy of clinical application.