微创医学

目的探讨不同浓度臭氧注射联合射频消融术治疗腰椎间盘突出症(LDH)的临床效果。方法将75例LDH患者随机分为A组、B组、C组，每组25例。3组患者均行臭氧注射联合射频消融术治疗，其中A组、B组、C组分别予40 mg/L、50 mg/L、60 mg/L医用臭氧注入病变椎间盘内。比较3组患者术前3 d、术后1 d、术后1个月、术后3个月、术后6个月的VAS评分和Oswestry功能障碍指数(ODI)评分。结果（1）术后各时间点，3组患者的VAS评分均较术前3 d低（均P＜0.05）。术后1 d、术后1个月及术后6个月，B组和C组患者的VAS评分均低于A组，且C组术后1 d和术后1个月的VAS评分均低于B组（均P＜0.05）；而术后3个月及6个月，B组与C组的VAS评分差异均无统计学意义（均P＞0.05）。（2）术后各时间点，3组患者的ODI评分均较术前3 d低（均P＜0.05）。术后1 d及术后1个月，B组和C组患者的ODI评分均低于A组，且C组的ODI评分低于B组（均P＜0.05）；术后3个月，C组患者的ODI评分低于A组（P＜0.05），而A组与C组、B组与C组的评分差异均无统计学意义（均P＞0.05）；术后6个月，3组患者的ODI评分差异无统计学意义（P＞0.05）。结论臭氧注射联合射频消融术治疗LDH可减轻患者腰部疼痛，促进腰部功能恢复。相对于40 mg/L和50 mg/L臭氧注射联合射频消融术，60 mg/L臭氧注射联合射频消融术治疗LDH的疗效更佳。

ObjectiveTo investigate the clinical effect of different concentrations of ozone injection combined with radiofrequency ablation in the treatment of lumbar disc herniation (LDH). MethodsA total of 75 LDH patients were randomly divided into group A, group B and group C, with 25 cases in each group. All patients in the three groups were treated with ozone injection combined with radiofrequency ablation, of which 40 mg/L, 50 mg/L and 60 mg/L medical ozone were injected into the diseased intervertebral disc in groups A, B and C, respectively. The VAS scores and Oswestry disability index (ODI) scores of the three groups were compared 3 days before surgery, 1 day after surgery, and 1, 3 and 6 months after surgery. Results(1) At each time point after surgery, the VAS scores of the 3 groups were lower than those 3 days before surgery (all P＜0.05). The VAS scores of group B and C were lower than those of group A 1 day, 1 month and 6 months after surgery, and the VAS scores of group C 1 day and 1 month after surgery were lower than those of group B (all P＜0.05). However, there was no significant difference in the VAS scores between group B and group C 3 or 6 months after surgery (all P＞0.05). (2) At each time point after surgery, the ODI scores of the three groups were lower than those 3 days before surgery (all P＜0.05). One day and 1 month after surgery, the ODI scores of group B and C were lower than that of group A, and the ODI score of group C was lower than that of group B (all P＜0.05). Three months after surgery, the ODI score of group C was lower than that of group A (P＜0.05), while there was no significant difference in the ODI scores between group A and group C, and between group B and group C (all P＞0.05). Six months after surgery, there was no significant difference in the ODI scores among the three groups (P＞0.05). ConclusionOzone injection combined with radiofrequency ablation in the treatment of LDH can reduce lumbar pain and promote the recovery of lumbar function. Compared with 40 mg/L and 50 mg/L ozone injection combined with radiofrequency ablation, 60 mg/L ozone injection combined with radiofrequency ablation is more effective in the treatment of LDH.