顾建钦　郑稼　刘珂

【摘要】 目的 探讨等离子刀联合臭氧髓核消融术治疗腰椎间盘突出症的临床疗效。方法 68例腰椎间盘突出症患者随机分为对照组和观察组， 各34例。对照组患者接受等离子刀髓核消融术治疗， 观察组患者接受等离子刀联合臭氧髓核消融术治疗。采用疼痛视觉模拟评分法（VAS）评估治疗前后腰腿痛程度， 比较两组治疗前后VAS评分及治疗后的临床效果。结果 两组治疗前及术后1个月VAS评分比较差异无统计学意义（P>0.05）， 术后12个月观察组VAS评分明显小于对照组（P<0.05）。观察组患者治疗后优良率明显高于对照组（94.12% vs 70.59%， χ2=6.476， P<0.05）。结论 等离子刀联合臭氧髓核消融术治疗腰椎间盘突出症疗效优于单纯的等离子刀治疗， 值得在临床中推广应用。

【关键词】 腰椎间盘突出症；等离子刀；臭氧；髓核消融术；疗效

DOI：10.14163/j.cnki.11-5547/r.2016.23.004

【Abstract】 Objective To investigate clinical effect by plasma knife combined with ozone nucleoplasty in the treatment of protrusion of lumbar intervertebral disc. Methods A total of 68 patients with protrusion of lumbar intervertebral disc were randomly divided into control group and observation group， with 34 cases in each group. The control group received plasma knife nucleoplasty for treatment， and the observation group received plasma knife combined with ozone nucleoplasty for treatment. Visual analogue scale （VAS） was applied to evaluate pain degree in waist and legs before and after treatment. Comparison was made on VAS scores and clinical effects between the two groups before and after treatment. Results There was no statistically significant difference of VAS scores between the two groups before treatment and in 1 month after treatment （P>0.05）. The observation group had obviously lower VAS score in 12 months after treatment than the control group （P<0.05）. Postoperative good rate was much higher in the observation group than the control group （94.12% VS 70.59%， χ2=6.476， P<0.05）. Conclusion Combination of plasma knife and ozone nucleoplasty shows better curative effect than single plasma knife in treating protrusion of lumbar intervertebral disc， and this method is worth clinical promotion and application.

【Key words】 Protrusion of lumbar intervertebral disc； Plasma knife； Ozone； Nucleoplasty； Curative effect

腰椎间盘突出症是骨科常见病， 近年来其发病率有明显上升趋势。统计表明在所有因为腰痛和腿痛而去骨科就诊的患者中大约10%的患者被诊断为腰椎间盘突出症， 我国每年约有150万人罹患此病[1]。目前临床上治疗该病的方法主要有保守治疗和手术治疗。保守治疗包括药物治疗和理疗按摩等， 虽然可以在一定程度上缓解腰腿疼痛， 但是并不能使已经突出的髓核充分回纳入椎间盘内， 不能从根本上解决问题， 而且容易反复发作， 给患者带来很多烦恼。外科手术治疗虽然具有一定的风险， 但是只要充分把握适应证， 选择合适的手术方法其术后效果仍然值得期待[2]。随着微创医学的发展， 骨科手术也进入了前所未有的微创时代。本院近年来开展等离子刀联合臭氧髓核消融术治疗腰椎间盘突出症患者， 本文对此进行研究分析， 现报告如下。