DSA引导下经皮穿刺髓核钳夹联合臭气消融治疗颈椎间盘突出症临床研究.docVIP

DSA引导下经皮穿刺髓核钳夹联合臭气消融治疗颈椎间盘突出症临床研究 　　【摘要】 目的：研究DSA引导下经皮穿刺髓核钳夹联合臭氧消融治疗颈椎间盘突出症的临床意义。方法：选择颈C4/5、C5/6、C6/7、C7/T1椎间盘突出症患者86例作为研究对象，钳夹组（A组）43例C6/7或C7/T1椎间盘突出患者采用DSA引导下经皮穿刺髓核钳夹联合臭氧消融治疗，射频组（B组）43例C4/5或C5/6椎间盘突出患者采用髓核射频热凝消融联合臭气消融术。观察比较两组各个时期的疼痛视觉模拟评分（visual analogue scale，VAS）以及临床疗效。记录手术过程中及术后的并发症。结果：两组术后24 h、72 h、1周，4周、12周VAS评分均低于术前，A组术后4周及12周的VAS评分低于B组，比较差异均有统计学意义（P0.05）。术后12周，A组优良率为91.3%，B组为80.5%，A组失败率为8.7%，B组为19.5%。两组均无严重并发症发生。结论：DSA引导下经皮穿刺髓核钳夹联合臭气消融术是目前治疗颈椎间盘突出症最安全、有效的治疗方法。 　　【关键词】 颈椎间盘突出症； 髓核钳夹； 射频热凝； 臭氧消融 　　【Abstract】 Objective：To study the clinical significance of DSA-guided percutaneous nucleus pulposus clamp combined with ozone ablation in the treatment of cervical disc hermiation.Method：86 patients with cervical intervertebral disc hermiation of C4/5，C5/6，C6/7 or C7/T1 were selected as the research objects.43 patients with cervical intervertebral disc hermiation of C6/7 or C7/T1 in the clamp group（group A） were treated with DSA-guided percutaneous nucleus pulposus clamp combined with ozone ablation.43 patients with cervical intervertebral disc hermiation of C4/5 or C5/6 in the radio frequency group（group B） were treated with radiofrequency thermocoagulation combined with ozone ablation.The VAS scores and clinical effects in different stages of the two groups were observed and compared.Complications during and after the operation were recorded.Result：24 hours，72 hours，1 week，4 weeks and 12 weeks after the operation，the VAS scores of the two groups were lower than before treatment.4 weeks and 12 weeks after the operation， the VAS scores of group A were lower than those of group B.The differences above were all statistically significant（P0.05）.12 weeks after the operation，the excellent and good rate of group A was 91.3%，group B was 80.5%.The failure rate of group A was 8.7%，group B was 19.5%.There were no serious complications happened in the two groups.Conclusion：At present，DSA-guided percutaneous nucleus pulposus clamp combined with ozone ablation is the most sa