目的 探讨在影像介导经皮穿刺下,分别采用射频热凝和射频热凝联合臭氧消融治疗腰椎间盘突出症的疗效.方法 2009年12月-2010年12月,通过影像介导经皮穿刺下治疗腰椎间盘突出症40例,其中A组采用射频热凝术15例,B组采用射频热凝联合臭氧消融术25例,分别采用视觉模拟评分法(VAS评分)及改良MacNab方法进行疗效评价及对比分析.结果 所有病例手术操作顺利,无严重并发症发生,术后症状均得到不同程度改善,其中B组的治疗效果优于A组(P ＜ 0.05).结论 影像介导经皮穿刺下治疗腰椎间盘突出症,具有手术创伤小、术后恢复快、安全并易于为患者接受的优点.同时,在同一路径下采取射频热凝结合臭氧注射的方法,其治疗效果优于单一的射频热凝术,是一种合理而有效的组合.%Objective To evaluate the clinical effect of imaging-guided percutaneous radiofrequency thermocoagulation combined with ozone injection in treating lumbar disc herniation, and to compare this technique with pure radiofrequency thermocoagulation therapy. Methods From December 2009 to Decemher 2010, a total of 40 patients suffering from lumbar disc herniation were treated with imaging-guided percutaneous interventional treatment in authors' hospital. Patients in group A ( n = 15 ) were treated with radiofrequency thermocoagulation, while patients in group B ( n = 25 ) were treated with radiofrequency thermocoagulation together with ozone injection ablation. The clinical effect was evaluated by using visual pain analog scales ( VAS ) and modified MacNab method. The results were analyzed and compared between the two groups. Results Technical success was achieved in all cases and no serious complications occurred.After the treatment different degrees of symptomatic improvement were obtained in all patients. The clinical effect of group B was much better than that of group A. Conclusion Imaging-guided percutaneous interventional treatment for lumbar disc herniation is a minimally invasive and safe technique with immediate clinical response. Therefore, it is easily accepted by patients. Besides, the simple combination of radiofrequency thermocoagulation with ozone injection ablation is more effective than that of single radiofrequency thermocoagulation. ( J Intervent Radiol, 2011, 20 : 822-825 )
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