摘要:目的:探討聯合應用激光汽化減壓(percutaneous laser disc discompression,PLDD)、射頻熱凝靶點消融、臭氧注射治療腰椎間盤突出癥的的個體化選擇。方法: 自2006年6月,在CT引導下選擇性聯合應用PLDD、射頻和臭氧治療腰椎間盤突出癥患者267例,突出椎間盤的特點個體化選擇穿刺路徑和治療方法;其中PLDD聯合臭氧治療92例(A組),射頻聯合臭氧治療67例(B組),PLDD、射頻和臭氧三者聯合治療108例(C組)。結果:所有患者均順利完成手術,于術后1周、1個月,3個月及6個月隨訪記錄VAS評分和Macanab優良率。三組患者VAS評分經方差分析,手術前、后有顯著性差異(Plt;0.05),術后1周至6個月的VAS評分統計無顯著性差異(Pgt;0.05);術后三組間VAS評分、Macanab優良率比較無顯著性差異(Pgt;0.05)。結論: 選擇性聯合應用微創技術進行個體化的立體治療,具有擴大微創手術適應癥、提高手術療效的優勢,值得推廣和利用。Abstract: Objective: To investigate the selectivity and individualization of using percutaneous laser disc discompression(PLDD) and ozone injection combined with radiofrequency thermocoagulation and target ablation curing lumbar intervertebral disc protrusion. Methods: From June 2006, 267 lumbar disc herniation cases were operated that guided by CT, the characteristic of the liable disc was confirmed by magnetic resonance imaging and CT before the procedure. 92 cases (A group) were treated by PLDD combined with ozone injection,67 case were treated by radiofrequency thermocoagulation and target ablation combined with ozone injection, 108 cases were treated by PLDD and ozone injection combined with radiofrequency thermocoagulation and target ablation. Results: All case been successfully operated, the theraptic effect was evaluated by comparing the value of VAS and excellent and good rate of therapy at preoperation and at 1 week, 1month,3 months, 6 months after operation. The value of VAS in three groups at postoperation were remarkably lower than preoperation (Plt;0.05). The excellent and good rate of therapy at 6 months was respectively 94.5％ in group A,94.0％ in group B and 95.4％ in group C,no significant difference was observed between the three groups(Pgt;0.05).Conclusion: The selectivity and individualization of using PLDD and ozone injection combined with radiofrequency thermocoagulation and target ablation curing lumbar intervertebral disc protrusion can enlarge the indication and improve the clinical curative effect, it should be spreaded in clinic.
ObjectiveTo explore the feasibility of medical ozone in treatment of pulmonary fibrosis. MethodsForty Wistar rats were randomly divided into an experimental group and a control group, with 20 rats in each group.All rats were intratreacheally instilled with bleomycin to induce pulmonary fibrosis.Then the rats were intraperitoneally injected with physiological saline every other day in the control group, and with medical ozone every other day in the experimental group.After 28 days, 10 rats in each group were sacrificed after lung function test.Right lung tissues were sampled for pathological examination, and left lung tissues were sampled for measurement of superoxide dismutase (SOD) and hydroxyproline.The remaining 10 rats in each group continued to be normally fed and intraperitoneally injected for observation of the survival time. ResultsThe lung function of the control group significantly decreased compared with the experimental group.The degree of lung fibrosis in the control group was more severe than that in the experimental group (lung fibrosis score: 1.9±0.5 vs.1.2±0.4, P < 0.05). The level of SOD in lung tissue was significantly higher and the level of hydroxyproline was significantly lower in the experimental group compared with the control group [(208.48±29.37)U·mg-1·pro-1 vs.(163.34±21.42) U·mg-1·pro-1, (2.25±0.28) mg/g vs.(2.68±0.37) mg/g, P < 0.05].The rats in the experimental group had longer survival time compared with the control group (79 d vs.59 d, P < 0.05). ConclusionMedical ozone can delay the progress of pulmonary fibrosis in rats.
ObjectiveTo investigate the effect of ozone on oxidative stress and energy metabolism change of blood from aortic dissection (AD) patients for providing preliminary evidence of application of ozonated autohemotherapy (ozone-AHT) in AD patients. MethodsTwenty AD patients (16 males and 4 females with a mean age of 48.51±10.21 years) were consecutively included in the First Affiliated Hospital of Harbin Medical University from March 2016 to August 2016, and blood samples were collected from all participants and ozonized in vitro at different ozone concentrations (0 μg/ml, 40 μg/ml, 60 μg/ml, 80 μg/ml, 160 μg/ml). Malondialdehyde (MDA), red blood cells (RBCs) superoxide dismutase (SOD), Na+-K+-ATP, 2,3-bisphosphoglyceric acid (2,3-DPG) at different ozone concentrations were evaluated by enzyme-linked immunosorbent assay (ELISA). ResultsIn the control group (0 μg/ml), the content of postoperative MDA was significantly higher than that of preoperation (P<0.05). The contents of postoperative SOD, Na+-K+-ATP and 2,3-DPG were significantly lower than that of preoperation (P<0.05). The content of MDA at the concentrations of 40 μg/ml, 60 μg/ml, 80 μg/ml group increased after the operation (P>0.05), and the SOD, Na+-K+-ATP, 2,3-DPG decreased compared with the preoperation (P>0.05). But all the values were not statistically significant at the concentrations of 40 μg/ml, 80 μg/ml and 160 μg/ml respectively between preoperation and postoperation (P>0.05). Compared with other concentration groups, the content of preoperative and postoperative MDA increased in the ozone group (160 μg/ml), and oppositely, the contents ofpreoperative and postoperative SOD, Na+-K+- ATP and 2,3-DPG decreased (P<0.05). Conclusion The concentrations of 40 to 80 μg/ml of ozone can improve the antioxidant capacity of erythrocyte membrane, reduce oxidative stress in blood samples of AD patients and improve the energy metabolism of erythrocyte membranes, so the concentration range of ozone is safe and feasible for the ozone-AHT of perioperative AD.