红外热像图在腰椎间盘突出症的功能评定及疗效评定中的应用价值

邓燕霞 梁芳 张志海 钟建华

[摘要] 目的 探討分析红外热像图在腰椎间盘突出症的功能评定及疗效评定中的应用价值。 方法 方便选取该院2016年1月—2017年1月收治的136例腰椎间盘突出症患者，对其采用微创治疗方式，其中腰椎椎间孔镜手术118例、腰椎椎间盘镜6例、腰椎射频消融术12例），分别在术前1～2 d、术后3 d、术后3个月对患者大腿、小腿以及足底体温使用红外热像图进行检测，对比分析健肢和患肢，分析术前和术后红外热像图温差与临床效果之间的关系。 结果 ①对比分析患侧和健侧下肢体温，在对患者测量之后，其大腿后外侧温度为（30.96±1.09）℃，大腿后侧为（33.35±1.06）℃，小腿后外侧为（30.68±1.04）℃，小腿后侧为（33.34±1.03）℃，足底部健侧温度为（29.19±1.04）℃，患侧温度为（27.25±1.05）℃，结果显示，健侧体温显著高于患侧体温（t=5.267，P=0.032 9）。②术前和术后红外热像图温差与临床效果之间的关系：术前术后采用视觉模拟评分法 （visual analogue scale， VAS）和 Macnab 疗效评价标准，其中优 122例，良 10例，一般3例，差 1 例，优良率 97%。红外热像采集双下肢皮肤的温差术前与术后比较明显下降，差异有统计学意义（P=0.041 2），结果表明，临床效果比较好的患者其患肢温差比较大。结论 给予腰椎间盘突出症患者红外热像图检查方式，能够显著反映出患者异常热区的分布范围，能够将其作为腰椎间盘突出症的功能评定以及疗效评定的重要指标。

[关键词] 红外热像图；腰椎间盘突出症；功能评定；疗效评定；应用价值

[中图分类号] R681.53 [文献标识码] A [文章编号] 1674-0742（2018）05（a）-0007-04

Application Value of Infrared Thermography in Evaluating the Function of Lumbar Intervertebral Disc Herniation and Its Curative Effect

DENG Yan-xia， LIANG Fang， ZHANG Zhi-hai， ZHONG Jian-hua

Pain Department， Fifth People's Hospital of Dongguan， Dongguan， Guangdong Province， 523900 China

[Abstract] Objective To explore the application value of infrared thermography in evaluating the function of lumbar intervertebral disc herniation and evaluation of its curative effect. Methods 136 cases of patients with prolapse of lumbar intervertebral disc in our hospital from January 2016 to January 2017 were convenient treated with the minimally invasive treatment methods， including 118 cases with lumbar intervertebral foraminoscopy， 6 cases with lumbar intervertebral foramen surgery and 12 cases with lumbar intervertebral disc endoscope lumbar radiofrequency ablation， and the upper and lower leg and foot temperatures were tested by the infrared thermography in the 1 to 2 days before surgery， and in 3 days and 3 months after surgery， and the healthy limb and affected limbs were compared， and the correlation between the temperature difference of infrared thermography and clinical effect before and after surgery was compared and analyzed. Results after measurement， the thigh posterolateral temperature was （30.96±1.09） ℃， posterior thigh side was （33.35±1.06）℃， calf posterolateral temperature was （30.68±1.04）℃， posterior calf side was（33.34±1.03）℃， lateral temperature of the foot was（29.19±1.04） ℃ and affected side temperature was（27.25±1.05）℃， and the results showed that the contralateral temperature was obviously higher than that of affected side temperature （t=5.267， P=0.032 9） ， and in terms of VAS and Macnab curative effect evaluation standards， 122 cases were excellent， 10 cases were good， 3 cases were in genera， and 1 case was bad， and the excellent and good rate was 97%， and the temperature difference of infrared thermal image acquisition of skin of double lower limbs obviously decreased， and the difference was statistically significant（P=0.041 2）， and the results showed that the temperature difference of affected limbs of patients with better clinical effect was bigger. Conclusion The infrared thermography in patients with prolapse of lumbar intervertebral disc can obviously reflect the distribution range of abnormal heat zone， and it can be used as a major indicator of functional evaluation and curative effect evaluation of lumbar intervertebral disc herniation.

[Key words] Infrared thermography； Lumbar intervertebral disc herniation； Functional evaluation； Curative effect evaluation； Application value

腰椎间盘突出症是较为常见的疾患之一，病因较多，主要是因……