摘要
目的:探讨CT引导下腰椎间盘化学松解微创介入手术在腰椎间盘突出症中的应用效果。方法:选取医院收治的98例腰椎间盘突出症患者,按照随机数表法将其分为观察组和对照组,每组49例。两组均借助CT行腰椎间盘化学松解术,观察组采用盘内盘外注射治疗方法,对照组仅行盘内注射治疗方法,对比分析两组患者术前和术后1个月视觉模拟量表(VAS)评分,随访患者术后1个月、3个月和6个月时的改良Macnab疗效评定疗效情况及并发症发生情况。结果:两组治疗后VAS评分均低于治疗前,且观察组治疗后VAS评分低于对照组,差异有统计学意义(t=28.57,P<0.01);观察组术后1个月、3个月和6个月时的治疗优良率分别为83.67%、87.76%和91.84%,对照组分别为79.59%、81.63%和85.71%,但两组比较差异均无统计学意义。随访期间,患者均无腰椎间盘感染、神经受损等相关并发症的发生。结论:借助CT行腰椎间盘化学松解术可有效减轻腰椎间盘突出症患者疼痛,且盘内盘外注射治疗的止痛效果更加明显。
Objective:To analyze the application of minimally invasive intervention surgery of lumbar disc chemical ablation under the guidance with computed tomography(CT)in protrusion of lumbar intervertebral disc.Methods:98 patients with protrusion of lumbar intervertebral disc were selected and were randomly divided into observation group and control group,with 49 cases in each group.Both groups underwent lumbar disc chemical ablation with the help of CT.The observation group adopted injection therapy within lumbar disc and outside of lumbar disc,and control group only adopted the injection therapy within lumbar disc.The visual analogue scale(VAS)scores before and 1 month after operation were recorded.The curative effects and complications of improved Macnab evaluation of therapeutic effects at the 1th month,the 3th months and the 6th months after operation were followed up.Results:The VAS scores of the two groups after treatment were significantly lower than those before treatment,and the VAS scores after treatment of observation group was significantly lower than those of control group(t=28.57,P<0.01).The excellent and good rates of observation group at the 1th month,the 3th months and the 6th months after operation were 83.67%,87.76%and 91.84%,respectively,and those of control group were 79.59%,81.63%and 85.71%,respectively.But there were no significant differences in these indicators between the two groups.During the follow-up period,there were no relevant complications such as lumbar disc infection and nerve damage in patients.Conclusion:The lumbar disc chemical ablation under the guidance with CT can effectively reduce the pain of patients with protrusion of lumbar intervertebral disc,and the analgesic effect of the injection within lumbar disc and out of lumbar disc is more obvious.
作者
董蕊
杨旭
徐幼苗
张志利
DONG Rui;YANG Xu;XU You-miao(Department of Pain,The First Hospital of Qinhuangdao,Qinhuangdao 066000,China)
出处
《中国医学装备》
2021年第12期42-44,共3页
China Medical Equipment
基金
河北省卫计委课题(20191380)“微创介入方法联合治疗腰椎间盘突出合并腰椎管狭窄的应用”。
关键词
腰椎间盘突出症
腰椎间盘化学松解术
CT引导
化学松解微创介入
Protrusion of lumbar intervertebral disc
Lumbar disc chemical ablation
Computed tomography:CT guidance
Chemical ablation intervention surgery
