CT引导下射频靶点热凝联合臭氧治疗腰椎间盘突出症的临床研究

施长生，吕维富，郑春生，黄柿兵，王安乐，杨龙林，王书健

·非血管介入Non-vascular intervention·

CT引导下射频靶点热凝联合臭氧治疗腰椎间盘突出症的临床研究

施长生，吕维富，郑春生，黄柿兵，王安乐，杨龙林，王书健

目的探讨CT引导下射频靶点热凝联合臭氧治疗腰椎间盘突出症的方法和疗效。方法回顾分析自2012年1月—2013年1月临床资料完整的84例采用射频靶点热凝联合臭氧治疗腰椎间盘突出症患者，采用视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）和改良MacNab标准评价治疗效果。结果①穿刺成功率98%，手术时间22～55 min，平均28 min。无神经血管损伤及椎间隙感染等并发症；②术后3 d，1周，6个月和12个月VAS评分分别为（4.0±8.3）、（3.6±0.7）、（2.9±0.7）和（3.0± 0.9），显著低于术前的VAS评分（7.2±1.1），P值均＜0.05；③术后3 d，1周，6个月和12个月ODI分别为（23.6±2.6）、（19.5±1.5）、（18.5±1.5）和（18.8±1.8），显著低于术前的（35.1±3.3），差异均有统计学意义（P＜0.05）；④术后1周、6个月和1年有效率分别为94.0%，95.2%，92.9%；优良率分别为77.4%，78.6%，73.8%。结论CT引导下射频靶点热凝联合臭氧治疗腰椎间盘突出症是安全、有效的方法，值得临床推广。

CT引导下；射频靶点热凝；臭氧；腰椎间盘突出症

【Abstract】ObjectiveTo discuss the technique and clinical effect of CT-guided radiofrequency target thermocoagulation combined with ozone injection in treating lumbar disc herniation.MethodsFrom January 2012 to January 2013 at authors'hospital，a total of 84 patients with lumbar disc herniation were treated with radiofrequency target thermocoagulation combined ozone injection.The clinical data were retrospectively analyzed，and the therapeutic effect was evaluated with visual analog score（VAS），Oswestry dysfunction index（ODI）and modified MacNab criterion.Results①The success rate of puncturing was 98%，and the operation time was 22-55 min，with an average of 28 min.No severe complications such as neurovascular impairment or intervertebral space infection occurred.②The VAS scores determined at 3 days，one week，6 and 12 months after the treatment were（4.0±0.8），（3.6±0.7），（2.9±0.7）and（3.0±0.9）respectively，which were significantly lower than the preoperative one（7.2±1.1），the difference was statistically significant（P＜0.05）.③Postoperative ODI values determined at 3 days，one week，6 and 12 months after the treatment were（23.6±2.6），（19.5±1.5），（18.5±1.5）and（18.8±1.8）respectively，which were significantly lower than the preoperative one（35.1±3.3），the difference was statistically significant（P＜0.05）.④The effect rates evaluated at one week，6 and 12 months after the treatment were 94.0%，95.2% and 92.9%respectively，while the excellent rates were 77.4%，78.6%and 73.8%respectively.ConclusionCT-guided radiofrequency target thermocoagulation combined with ozone injection is a safe and effective treatment for lumbar disc herniation.（J Intervent Radiol，2015，24：134-137）

【Key words】CT guidance；radiofrequency target thermocoagulation；ozone；lumbar disc herniation

腰腿痛是临床最常见的病症之一。腰腿痛患者中多数是由腰椎间盘突出（LDH）所致。介入治疗LDH越来越受到患者的接受。我科采用射频靶点热凝联合臭氧治疗腰椎间盘突出症84例，效果满意，现报道如下。

1　材料与方法

1.1材料

1.1.1一般资料本院2012年1月—2013年1月住院治疗LDH患者127例，84例得到完整随访。84例中男52例，女32例，年龄36～72岁，平均52岁。病程3个月至10年。术前均经保守治疗效果不满意。临床症状有：腰痛伴一侧或双侧下肢放射痛58例，单纯腰痛26例。所有患者均经CT或MR检查确诊。……