低温等离子髓核消融术治疗高原地区椎间盘源性下腰痛的疗效及对患者生活质量的影响

目的:研究低温等离子髓核消融术(LTPNPA)治疗高原地区椎间盘源性下腰痛(DLBP)的疗效及对患者生活质量的影响。方法:选择从2015年9月到2017年1月在我院接受治疗的高原地区DLBP患者,随机分为对照组(n=59)和观察组(n=59),对照组患者给予常规腰椎牵引治疗,观察组患者则予以LTPNPA术式治疗,对所有患者进行为期6个月的随访,并对比两组疗效、临床指标(疼痛缓解时间和住院时间)、治疗前后的椎间隙高度R值和Oswestry功能障碍指数(ODI)评分以及不同时期的日常生活能力量表(ADL)评分。结果:观察组的优良率是98.31%,高于对照组的88.14%(P0.05)。观察组的疼痛缓解时间及住院时间均少于对照组(P0.05)。治疗后两组的ODI评分均低于治疗前,且观察组较对照组偏低(P0.05)。治疗后两组的椎间隙高度R值相比差异无统计学意义(P0.05)。治疗后1个月、3个月、6个月两组的ADL评分均高于治疗前,治疗后3个月和6个月高于治疗后1个月,治疗后6个月高于治疗后3个月,且观察组均较对照组偏高(P0.05)。结论:对高原地区DLBP患者应用LTPNPA术式治疗,具有明显疗效,还可提升其生活质量,临床上可考虑在高原地区推广LTPNPA术式,从而使患者获得最佳疗效。

Effect of Low Temperature Plasma Nucleus Pulposus Ablation on Discogenic Low Back Pain in Plateau Area and its Influence on Quality of Life

ABSTRACT Objective: To study the effect of low temperature plasma nucleus pulposus ablation (LTPNPA) on discogenic low back pain (DLBP) in plateau area and its influence on quality of life. Methods: 118 patients with DLBP in plateau area treated in our hospital from September 2015 to January 2017 were selected, they were randomly divided into control group (n=59) and observation group (n=59). The control group was treated with conventional lumbar traction, and the observation group was treated with LTPNPA, all pa- tients were followed up for 6 months, the curative effect, the clinical indicators (pain relief time and hospitalization time), Rvalue of inter- vertebral space height before and after treatment, oswestry disability index (ODI) score and ability of daily life in different periods of scale (ADL) score between the two groups were compared. Results: The excellent and good rate of the observation group was 98.31%, significantly higher than 88.14% of the control group (P<0.05). The pain relief time and hospitalization time of the observation group were significantly less than those of the control group (P<0.05). The ODI scores of the two groups after treatment were significantly lower than before treatment, and the observation group was significantly lower than the control group (P<0.05). There was no significant differ- ence in R value of intervertebral space height between the two groups after treatment (P>0.05). The ADL scores of the two groups at 1 month, 3 months and 6 months after treatment were significantly higher than those before treatment, and which at 3 months and 6 months after treatment were significantly higher than 1 month after treatment, which 6 months after treatment was significantly higher than 3 months after treatment, and the observation group were significantly higher than the control group (P<0.05). Conclusion: LTPNPA treat- ment is an effective method for the treatment of DLBP in plateau area, can improve the quality of life, clinical should consider LTPNPA operation in plateau areas, so that patients can get the best curative effect.