针刀联合椎间孔针闭合松解治疗腰椎间盘突出症临床研究

目的：观察针刀联合椎间孔针闭合松解术治疗腰椎间盘突出症的临床疗效。方法：选取2011年3月1日－2012年6月1日我院收治的腰椎间盘突出症患者61例，采用简单随机法，根据SAS统计软件，将61例腰椎间盘突出症患者随机分为治疗组与对照组，治疗纽30例，男16例，女14例，年龄（4（1．3±4．8）岁，病程（4．9±3．2）年，治疗前lOA腰腿痛疾患评分（8．1±4．7117）分。对照组31例，男18例，女13例，年龄（40．6±4．4）岁，病程（5．0±3．8）年，治疗前IOA腰腿痛疾惠评分（9．75±38096）分，两组基础资料比较无统计学差异。治疗组给予针刀椎管外闭合松解联合椎间孔针椎管内闭合松解，对照组给予针刀椎管外闭合松解。于治疗结束后30d及180d后随访，根据JOA腰腿痛疾患疗效评分表进行评分，其中包括下腰痛、肢体疼痛和麻木、步态、临床体征、日常活动受限度、膀胱功能等．结果：两组患者治疗后30d JOA评分较治疗前均有所提高，且有统计学差异（P〈0．01），说明两种治疗方案均可使症状明显改善；组间比较治疗组优于对照组（P〈0．05），说明治疗组疗效更好。治疗后180d，治疗组JOA评分与治疗后30d时相近，说明治疗组远期疗效稳定，对照组JOA评分与治疗后30d相比稍有下降，说明远期疗效不够稳定。180d后综合疗效比较，治疗组优良率优于对照组（P〈0.05），说明治疗组的远期疗效明显优于对照组。结论：与单纯针刀椎管外闭合松解相比，针刀椎管外闭合松解联合椎间孔针椎管内闭合松解可明显提高腰椎间盘突出症的治疗效果，长期疗效稳定，且操作简便、安全。

Clinical Study on Treating Lumbar Disc Herniation with Methods of NeedleKnife Combined with Intervertebral Foramen Needle Closed Lysis

Ohjective： To observe the clinical curative effect of needle-knife combined with intervertebral foramen needle closed lysis to treat lumbar disc herniation. Method： 61 cases of lumbar disc prolapse were select en in our hospital from March 1,2011 to June 1,2012. According to SAS statistical software,61 cases were randomly divirlerl into treatment group and control group by using simple random method. Treatment group had 30 cases, 16 males and 14 females. The avarge age was 40.3 ± 4.8 years old, ann the average duration was 4.9 ± 3.2 years. JOA score was 8.1 ± 4.7117 before the treatment. Control group han 31 cases, 18 males and 13 females. The average age was 40.6 ± 4.4 years old, and the duration was 5.0 ± 3.8 years before the treatment. The JOA score was 9.75 ± 3.8096 before the treatment. The two groups showen no significant difference in the underlying data. The treatment group rer.eived the treatment of needle-knife lysis combined with the intervertebral foramen needle closed lysis in the spinal canal, and the control group received the treatment of needle-knife lysis outside the spinal canal. 30 days and 180 days after the treatment, low back pain disorders, including lower back pain, limb pain and numbness, gait, clinical signs, subject to the limits daily activities and bladder function were graded according to JOA score. Result： 30 days after treatment, two groups patients＇ JOA scores were improved, and there was significant difference （P〈O.OI ）, indicating the two treatment regimens can make significant improvement in symptoms. The treatment group was superior to the control group （P〈0.05 ）, indicating that the treatment group had better efficacy. 180 days after treatment, the treatment group＇s JOA score was similar to that 30 days after treatment, indicating the long-term efficacy was stable. The control group＇s JOA score was slightly decreased compared with that 30 days after treatment, indicating the long-term efficacy was not stable enough. 180 days after treatment, the comprehensive efficacy of the treatment group was better than that of the control group （P〈O.OI ）, indicating the long-term efficacy of the treatment group was better. Conclusion： Compared to needle-knife lysis, needle-knife lysis combined with intervertebral foramen needle closed lysis in the spinal canal can significantly improve the treatment of lumbar disc herniation and the long-term efficacy is stable, and it is easy to operate and safe.