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低温等离子消融联合胶原酶注射治疗腰椎间盘突出症的临床观察。

Clinical observation of low temperature plasma ablation combined with collagenase injection in lumbar disc herniation.

机构信息

Department of Pain, Nanchong Central Hospital (Nanchong Hospital, Beijing Anzhen Hospital)/The Second Clinical School of North Sichuan Medical College, Nanchong, Sichuan, China.

出版信息

Medicine (Baltimore). 2024 Sep 20;103(38):e39739. doi: 10.1097/MD.0000000000039739.

Abstract

To observe the effect of low temperature plasma ablation combined with collagenase injection on lumbar disc herniation. 90 patients with lumbar disc herniation admitted to the pain department of our hospital and receiving surgical treatment from April 2021 to April 2023 were included in this retrospective study, and were divided into 2 groups according to different treatment plans. One group was treated with low-temperature plasma ablation combined with collagenase injection, and the other group was treated with low-temperature plasma ablation alone. The sample size of both groups was 80 cases. Peripheral blood was collected by fasting in the morning at 5 time points before surgery, 1, 3, 7 and 14 days after surgery, and 5 mL of whole venous blood was collected by disposable vacuum blood collection device. Serum levels of pro-inflammatory factor interleukin (IL)-1α, IL-1β, IL-6, IL-8, tumor necrosis factor-α and anti-inflammatory factor IL-4, IL-10 were detected by ELISA. VAS scores were used to evaluate postoperative low back pain. ODI and Lehmann Lumbar Function Scale were used to evaluate postoperative lumbar function. The contents of IL-1α, IL-1β, IL-6, IL-8, tumor necrosis factor-α and anti-inflammatory factor IL-4, IL-10 in the cryo-plasma ablation combined with collagenase injection group were significantly lower than those in the cryo-plasma ablation group alone (P < .05). The VAS score of cryo-plasma ablation combined with collagenase injection group was significantly lower than that of cryo-plasma ablation group at 1 day and 3 months after treatment, and the difference was statistically significant (P < .05). The ODI score of cryo-plasma ablation combined with collagenase injection group was significantly lower than that of cryo-plasma ablation group at 1 day and 3 months after treatment, and the difference was statistically significant (P < .05). The Lehmann score of cryo-plasma ablation combined with collagenase injection group was significantly higher than that of cryo-plasma ablation group at 1 day and 3 months after treatment, and the difference was statistically significant (P < .05). The overall efficacy of low-temperature plasma ablation combined with collagenase injection is better than that of low-temperature plasma ablation alone. Low temperature plasma ablation combined with collagenase injection in the treatment of patients with lumbar disc herniation has less pain, faster recovery.

摘要

观察低温等离子消融联合胶原酶注射治疗腰椎间盘突出症的效果。将 2021 年 4 月至 2023 年 4 月我院疼痛科收治并行手术治疗的 90 例腰椎间盘突出症患者纳入本回顾性研究,根据不同治疗方案分为两组,一组采用低温等离子消融联合胶原酶注射治疗,另一组采用低温等离子消融单纯治疗,每组样本量 80 例。术前 5 个时间点(清晨空腹)、术后 1、3、7、14 d 采集外周血 5mL,采用一次性真空采血管采集全静脉血,采用酶联免疫吸附法检测促炎因子白细胞介素(IL)-1α、IL-1β、IL-6、IL-8、肿瘤坏死因子-α和抗炎因子 IL-4、IL-10。采用视觉模拟评分(VAS)评估术后腰痛,采用 Oswestry 功能障碍指数(ODI)和 Lehmann 腰椎功能评分评估术后腰椎功能。低温等离子消融联合胶原酶注射组的 IL-1α、IL-1β、IL-6、IL-8、肿瘤坏死因子-α和抗炎因子 IL-4、IL-10 含量均明显低于单纯低温等离子消融组(P<0.05)。低温等离子消融联合胶原酶注射组治疗后 1 d 和 3 个月的 VAS 评分明显低于单纯低温等离子消融组,差异有统计学意义(P<0.05)。低温等离子消融联合胶原酶注射组治疗后 1 d 和 3 个月的 ODI 评分明显低于单纯低温等离子消融组,差异有统计学意义(P<0.05)。低温等离子消融联合胶原酶注射组治疗后 1 d 和 3 个月的 Lehmann 评分明显高于单纯低温等离子消融组,差异有统计学意义(P<0.05)。低温等离子消融联合胶原酶注射的整体疗效优于单纯低温等离子消融。低温等离子消融联合胶原酶注射治疗腰椎间盘突出症患者疼痛较轻,恢复较快。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31e1/11419459/3eee7c63912e/medi-103-e39739-g001.jpg

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