射频热凝与亚甲蓝注射治疗盘源性腰痛的疗效比较

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1650 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的比较射频热凝与亚甲蓝注射治疗椎间盘造影纤维环完全破裂造影剂漏至盘外类型的盘源性腰痛的近期疗效。方法 2020年4月至2021年4月，自贡市第四人民医院收治的72例临床诊断为盘源性腰痛，且椎间盘造影阳性患者，其中40例纤维环完全破裂造影剂漏至盘外，按入院顺序单双号随机将患者分为两组。A组20例行射频热凝治疗，男15例，女5例；年龄23～58岁，平均(47.41±11.46)岁。B组20例行亚甲蓝注射治疗，男14例，女6例；年龄29～65岁，平均(48.23±7.70)岁。治疗前后采用疼痛视觉模拟评分(visual analogue scale，VAS)和日本骨科协会评分(Japanese orthopaedic association，JOA)进行评价。结果所有患者均获随访，随访时间8～14个月，平均随访(12.00±1.65)个月。组内VAS与JOA评分术前、术后末次随访比较，差异有统计学意义(P＜0.05)。组间VAS与JOA评分术前比较，差异无统计学意义(P＞0.05)；术后末次随访比较，差异有统计学意义(P＜0.05)。A组治疗改善率平均(81.65±13.37)%，优良率94.45%；B组平均(30.67±16.79)%，优良率16.78%，组间比较差异有统计学意义(P＜0.05)。所有患者均未发生重要血管神经损伤、感染等并发症。结论对于椎间盘造影纤维环完全破裂造影剂漏至盘外类型的盘源性腰痛，射频热凝的疗效优于亚甲蓝注射，建议此类型的盘源性腰痛采用射频热凝治疗。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	王翔奕
	刘世伟
	张进
	文超

关键词 ：椎间盘, 射频, 亚甲蓝

Abstract：Objective To compare the short-term efficacy of radiofrequency thermocoagulation and methylene blue injection in the treatment of discogenic low back pain with complete rupture of intervertebral disc contrast annulus and leakage of contrast medium outside the disc.Methods From April 2020 to April 2021，72 patients with discogenic low back pain and positive discography were treated in Zigong Fourth People’s Hospital，including 40 patients with complete rupture of fibrous ring and leakage of contrast medium outside the disc.The patients were randomly divided into two groups according to the order of admission.In group A，20 patients were treated with radiofrequency thermocoagulation，including 15 males and 5 females.The age ranged from 23 to 58 years，with an average of (47.41±11.46)years.Group B was treated with methylene blue injection，including 14 males and 6 females，aged from 29 to 65 years，with an average of (48.23±7.70)years.Visual analogue scale(VAS) and Japanese Orthopedic Association(JOA) were used to evaluate the pain before and after treatment.Results All patients were followed up for 8 to 14 months，with an average of (12.00±1.65)months.VAS and JOA scores in the group were significantly different in preoperative and postoperative follow-up (P＜0.05).There was no statistically significant difference in VAS and JOA scores between the groups before surgery (P＞0.05)，and there was a statistically significant difference in the last follow-up after surgery (P＜0.05).The treatment improvement rate in group A was (81.65±13.37)%，and the excellent rate was 94.45%.In group B，the average was (30.67±16.79)%，the excellent rate was 16.78%.The difference between groups was statistically significant (P＜0.05).All patients had no serious vascular nerve injury，infection and other complications.Conclusion Radiofrequency thermocoagulation is more effective than methylene blue injection for discogenic low back pain with complete rupture of discography annulus and leakage of contrast medium outside the disc.Radiofrequency thermocoagulation is recommended for this type of discogenic low back pain.

Key words： intervertebral disc radiofrequency methylene blue

作者简介: 王翔奕(1982－ )，男，副主任医师，自贡市第四人民医院康复疼痛科，520wxy718@163.com。

引用本文:

王翔奕，刘世伟，张进，文超. 射频热凝与亚甲蓝注射治疗盘源性腰痛的疗效比较[J]. 实用骨科杂志, 2022, 28(4): 313-316.
Wang Xiangyi，Liu Shiwei，Zhang Jin，Wen Chao. Efficacy Comparison of Radiofrequency Thermocoagulation and Methylene Blue Injection for Treatment of Discogenic Low Back Pain. sygkzz, 2022, 28(4): 313-316.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2022/V28/I4/313

［1］王宏杰，张永兴，赵庆华.椎间盘源性腰痛疼痛机制的研究进展［J］.中国矫形外科杂志，2019，27(3)：248-250.
［2］DePalma MJ，Ketchum JM，Saullo T.What is the sourceof chronic low back painand does age play a role?［J］.PainMed，2011，12(2)：224-233.
［3］彭宝淦.椎间盘源性腰痛的诊疗进展［J］.中国疼痛医学杂志，2015，21(5)：321-326.
［4］Nakashima H，Kawakami N，Tsuji T，et al.Adjacent segmentdisease after posterior lumbar interbody fusion：basedon cases with a minimum of 10 years of follow-up［J］.Spine (Phila Pa 1976)，2015，40(14)：E831-E841.
［5］王玲，曹正培.射频热凝术治疗盘源性腰痛的临床疗效观察［J］.当代医学，2018，24(31)：102-103.
［6］吴贤良，黄建军，庄培峰.亚甲蓝注射与斜前方腰椎融合术治疗椎间盘源性下腰痛的临床疗效［J］.中国骨与关节损伤杂志，2020，35(5)：504-507.
［7］史剑倩，章勇，张达颖，等.亚甲蓝注射联合靶点射频治疗盘源性腰痛的临床疗效研究［J］.中国疼痛医学杂志，2015，21(10)：791-793.
［8］马俊杰，陈海龙.椎间盘源性腰痛患者SPECT/CT表现与椎间盘造影的比较研究［J］.中华骨与关节外科杂志，2021，14(8)：703-706；726.
［9］Garcia-Cosamalon J，del valle ME，Calavia MG，et al.Intervertebralidsc，sensory nerves and neurotrophins：who is who in discogenic pain?［J］.J Anat，2010，217(1)：1-15.
［10］沈锋，刘观燚，胡利华，等.椎间盘内注射亚甲蓝治疗椎间盘源性腰痛的研究进展［J］.中医正骨，2021，33(1)：48-51；55.
［11］庞晓东，徐展，彭宝淦，等.亚甲蓝治疗椎间盘源性下腰痛机制的动物实验研究［J］.中国疼痛医学杂志，2011，17(5)：274-279.
［12］刘洋，刘忠军，王静成，等.亚甲蓝对大鼠椎间盘纤维环细胞增殖及凋亡的影响［J］.中国脊柱脊髓杂志，2018，28(3)：245-252.