腰椎间盘突出症射频消融术后康复治疗与常规治疗疗效比较

 目的 探讨射频消融髓核成形术后康复治疗的方法及疗效。 方法 对2007-06至2009-06确诊为腰椎间盘突出症的患者60例，随机分为康复治疗组（27例）与常规治疗组（33例）。康复治疗组术后1 d开始如下康复治疗：中频治疗、牵引治疗和运动治疗等；出院指导包括佩戴腰围、睡硬板床、避免弯腰及腰过伸等动作，2个月内禁止弯腰举重物。 结果 两组患者术后均有一定程度的恢复，腰腿疼痛症状明显缓解或消失，与术前比较差异有统计学意义。术后1 d两组患者症状均有明显改善，康复治疗组VAS由术前的平均7.5分降至3.2分，常规治疗组由7.8分降至3.7分。术后3～7 d因局部水肿压迫疼痛有所加重，之后会继续减轻，腰椎功能进一步提高。康复治疗组3d后症状加重不明显，且远期疗效显著，术后3个月VAS平均1.3分。 结论 腰椎射频消融术后积极配合康复治疗，能及时缓解并消除神经根水肿的症状，减轻局部炎性反应，促进神经的恢复，消除疼痛。对改善患者的腰腿活动能力、增强手术疗效、避免再次复发等起到积极的促进作用。

Rehabilitation after lumbar intervertebral disc operation of hypothermia plasma radio frequency

Objective To study the method and curative effect of rehabilitation in patients after hypothermia plasma radiofrequency current ablation nucleoplasty.Methods From June 2007 to June 2009,60 patients with definite diagnosis of lumbar intervertebral disc protrusion were randomly assigned to the treatment group(27 cases)and conventional group(33 cases).On postoperative day 1,the patients in treatment group began to undergo rehabilitative treatment,including ultra-short wave,midband treatment,traction treatment and exercise treatment.On discharge from the hospital,patients were advised to take some precautions.Results The two groups showed some degree of recovery,with significant difference from the preoperative status.The pain of the waist and leg was markedly released or disappeared.The symptoms in the two groups were obviously ameliorated after operation.VAS dropped from 7.5 to 3.2 in the treatment group and from 7.8 to 3.7 points in the common group.Compression pain and local edema were serious in postoperative 3-7 days but were alleviated gradually.After three months,VAS decreased to 1.3 in the treatment group and symptoms were not aggravated obviously.Conclusions Postoperative rehabilitation management,including elimination of inflammation,detumescence,amelioration of blood circulation,relief of pain and exercise,can relieve and eliminate symptoms of edema of the nerve root,lessen local inflammatory reaction,promote recovery of the nerve and eliminate the pain.The rehabilitation management improves locomotive activity of the leg and waist,reinforces the surgical curative effect,and prevents relapse.