CT引导下应用不同臭氧注射法及PLD治疗腰椎间盘突出症的对比研究

摘要

目的:分析不同臭氧注射方法及经皮腰椎间盘摘除术(PLD)治疗腰椎间盘突出症(LDH)的疗效及不良反应,探讨其治疗的安全性.材料和方法:将300例LDH患者随机分成A、B、C三组,每组100例.A组:运用弯套针旋转多向注射臭氧治疗;B组:运用常规方法注射臭氧;C组:运用PLD治疗.统计治疗后1周和6个月时的疗效及患者出现并发症和"反跳"现象的例数,进行统计学分析.结果:痊愈显效率A、B、C 三组在1周时分别为60%、55%和40%;在6个月时分别为85%、69%和72%.痊愈显效率比较:治疗后1周,A与B组差异无显著性意义(P＞0.05),A与C组、B和C组差异均有显著性意义(P＜0.01和0.05);治疗后6个月,A与B组、A与C组差异均有显著性意义(P＜0.01和0.05),B和C组差异无显著性意义(P＞0.05).A、B、C三组并发症发生率分别为13%、12%和28%,A、B两组无明显差别(P＞0.05),C组明显高于A和B组(P＜0.01).A、B、C三组"反跳"发生率分别为10%、20%和27%,A组明显少于B、C组(P＜0.05和0.01),B组少于C组,但无显著性差异.结论:臭氧常规注射治疗LDH与PLD具有相似疗效,而采用弯套针旋转多向注射法可以进一步提高疗效;PLD与O3治疗均具有微创与并发症较少等优点,但是O3治疗与PLD相比并发症更少,并发症的严重程度更轻;弯套针旋转多向注射法是一种安全可靠的方法,值得临床推广应用.%Purpose To analyze the curative effect and adverse reaction of ozone injection by different method and percutaneous lumbar disketomy in treatment of lumbar disc herniation(LDH), and to discuss their safety of treatment.Materials nnd Methods 300 cases of LDH were randomly divided into three groups of A、 B and C, 100 cases in each group.Group A was treated to inject ozone with Curving Sheath-needle Multi-direction Rotating Injection(CSNMRI), group B was treated with conventional injection method, group C was treated with percutaneous lumbar disketomy.To figure respectively their curative effect after 1 week and 6 months of treatment.Additionally to count the case number of complication and “setback” phenomenon in 3 groups.Results The cured and markedly effective rates of group A、B and C were 60％ 、55％ and 40％ after a week and 85％ 、69％ and 72％after 6 months.The cured and markedly effective rate comparison: At a week after treatment, group A and B have no significant difference(P＞0.05), group A and C、 group B and C both have significant difference(P＜0.05 and 0.01) ;After six months, group A and B、 group A and C have both significant difference(P＜0.01 and 0.05).group B and C have no significant difference(P＞0.05).In the three groups, the rates of setback phenomenon are 13％ 、12％ and 28％, group A is less than group B and C significantly(P＜0.05 and 0.01), group B is also less than group C, but they have no significant difference.Conclusions The curative effect of ozone in treatment of LDH with conventional injection method is similar to PLD, but CSNMRI can improve the curative effect.Both PLD and ozone treatment have the strongpoints of micro-wound and little complication, but ozone have less complication than PLD, and the complication is more slight.CSNMRI is worth to be generalized and applied because it is safe and reliable.