CT 引导下靶向置管臭氧溶盘治疗腰椎间盘突出症140 例评价.PDF

中国疼痛医学杂志Chinese Journal of Pain Medicine 2014,20 (5) 325 · · doi:10.3969/j.issn.1006-9852.2014.05.010 CT 引导下靶向置管臭氧溶盘治疗 腰椎间盘突出症 140 例评价 ∆ 孙永海 路桂军 赵国利 杨 静 刘智慧 （中国人民解放军总医院麻醉手术中心疼痛治疗科，北京 100853 ） 摘 要 目的：评价突出物靶向置管臭氧溶盘对腰椎间盘突出症的治疗效果。方法：腰间盘突出症 患者140 例，在CT 引导下经安全三角入路，利用记忆金属导丝靶向将导管置入突出物内，注射浓 度为60 µg/ml 的医用臭氧10 ml，术后1 周内每天注射60 µg/ml 的医用臭氧10 ml，一周以后拔管； 术后1 周、3 个月进行患者VAS 评分并评估疼痛缓解程度；并观察有无神经损伤、感染、误入蛛网 膜下腔等并发症的发生；术后3 个月随访或患者复诊，了解症状改善情况，依据改良的MacNab 腰 腿痛手术评价标准评价治疗效果，并观察并发症发生情况。结果：治疗后1 周、3 个月VAS 评分较 术前均明显降低（P 0.01 ）；术后3 个月治疗总有效率达99.3% ，优良率92.9% ，无效率为0.7%。 术后一周内有5 例疼痛加重，但三个月后明显缓解，无其他并发症发生。结论：突出物靶向置管臭 氧溶盘对腰间盘突出症治疗效果确切，安全性好。 关键词 靶向置管；腰椎间盘突出症；臭氧 EVALUATION OF 140 PATIENTS WITH LUMBAR DISC HERNIATION TREATED WITH OZONE BY CT-GUIDED CATHETER INTO TARGET SUN Yong-Hai ∆, LU Gui-Jun, ZHAO Guo-Li, YANG Jing, LIU Zhi-Hui (Department of Anesthesia and Surgery Center Pain Management Branch, Chinese PLA General Hospital, Beijing 100853) Abstract Objective: To evaluate the therapeutic effect of lumbar disc herniation treated with ozone through a catheter inserted into disc. Methods: Catheters were inserted into lumbar ruptured disk of 140 patients with lumbar disc herniation through safety triangle approach, guided by CT and assisted with memory metal guide wire. Ten milliliter medical ozone of 60 ug/ml was injected through catheter just after the operation, and injected every day within the first week postoperation. Catheter was then removed. At 1st and 3rd months after operation VAS scores and the degree of pain relief of all patients were measured, and complications including nerve injur