射频热凝靶点消融术在颈腰椎间盘突出症中的应用_临床医学论文.docVIP

射频热凝靶点消融术在颈腰椎间盘突出症中的应用_临床医学论文 射频热凝靶点消融术在颈腰椎间盘突出症中的应用_临床医学论文 作者：王锁良，吕建国，申晓东，王忠华 【摘要】 目的 观察射频热凝靶点消融术在治疗颈腰椎间盘突出症中的疗效及安全性，并对该新技术的推广应用做出评估。方法 对120例经CT或MRI检查确诊的颈腰椎间盘突出症患者，根据临床症状、CT或MRI结果确定射频热凝的靶点位置，在C 型臂引导下穿刺到靶点，通过椎间盘造影确定电极已进入靶点，再行阻抗测试、电生理测试及温度测试后，给予86-94 ℃温度，对靶点进行热凝消融。此时，通常可以复制出原有的腰腿痛症状，用此温度治疗4个周期，每个周期100 s。结果 本组120例患者，经过该技术治疗后，其中73例治疗效果达优级，30例治疗效果良好，13例效果较差，4例无效，优良率85.8%。有4例患者术后并发轻微头痛、头晕等不适症状，均于2日内消失。余无其他并发症。结论 射频热凝靶点消融术是目前治疗腰椎间盘突出症的最新的、且安全有效的方法。 【关键词】 射频热凝；靶点消融术；椎间盘突出症 　　ABSTRACT: Objective To observe the effects and safety of radiofrequency thermocoagulation and target ablation in the treatment of cervical and lumbar intervertebral disc herniation, and to evaluate the clinical application of the new technique. Methods A total of 120 cervical and lumbar intervertebral disc herniation patients were diagnosed by CT or MRI. We located the target of radiofrequency thermocoagulation and ablation according to the clinical symptom, CT or MRI findings. The target was punctured under the guide by x-arm and confirmed the electrode enter the located target by contrast examination of intervertebral disc, and then by test of impedance, electrophysiology, temperature and then began to ablate the target 4 circles, with 100s for each period. It could also copy out the intrinsic neuralgia at the therapied moment. Results In the 120 patients, 73 patients gained excellent effects, 30 patients obtained good effects, 13 patients had poor effects and 4 cases had no effects. with the excellent and good rate of 85.8%. 4 cases mild headache and dizziness occurred after treatment and recovered within 2 days but no other complications occurred. Conclusion Radiofrequency thermocoagulation and target ablation is a new, safe and efficient technique in treating cervical and lumbar intervertebral disc herniation. 　　KEY WORDS: radiofrequency thermocoagulation; target ablation; intervertebral disc herniation 颈腰椎间盘突出症是临床多发病，是因椎间盘变性、纤维环破裂、髓核突出刺激或压迫神经根、马尾神经所表现的一种综合征，严重影响患者的社会工作和家庭生活。目前，对该病的治疗方法虽较多但近期及远期