目的 研究体外冲击波治疗腰椎间盘突出症的疗效及凝血功能、血小板参数的影响。方法 以2021年12月至2022年12月我院收治的113例腰椎间盘突出症为研究对象,采用随机数字表法将患者分为对照组(56例)和观察组(57例)。对照组采用常规治疗,观察组在常规治疗基础上加用体外冲击波治疗。比较两组临床疗效、治疗前、治疗10d后日本骨科科学会(JOA)、视觉模拟疼痛评分法(VAS)、Oswestry功能障碍指数问卷表(ODI)评分、血小板参数[血小板计数(PLT)、平均血小板体积(MPV)、血小板压积(PCT)]、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)]、血清炎症介质[肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、CXC趋化因子配体10(CXCL10)、α-颗粒膜糖蛋白(CD62P)]水平。结果 观察组临床总有效率96.49%(55/57)高于对照组83.93%(47/56,P＜0.05)；治疗10d后观察组VAS、ODI评分低于对照组,JOA评分高于对照组(P＜0.05)；治疗10d后观察组PLT、MPV、PCT低于对照组,血清PT、APTT高于对照组(P＜0.05)；治疗10d后观察组血清TNF-α、IL-8、CXCL10、CD62P水平低于对照组(P＜0.05)。结论 体外冲击波治疗腰椎间盘突出症患者疗效显著,可有效改善临床症状,调节血小板参数及凝血功能,缓解炎症反应。

Objective To study the efficacy of extracorporeal shock wave treatment for lumbar disc herniation and the effect of coagulation function and platelet parameters. Methods One hundred and thirteen cases of lumbar disc herniation admitted to our hospital from December 2021 to December 2022 were used as study subjects, and the patients were divided into control group (56 cases) and observation group (57 cases) using the random number table method. The control group was treated with conventional treatment, and the observation group was treated with extracorporeal shock wave on top of conventional treatment. To compare the clinical efficacy of the two groups, the Japanese Orthopaedic Association (JOA) before and after 10 d of treatment, visual analogue pain scoring (VAS), Oswestry Dysfunction Index Questionnaire (ODI) scores, platelet parameters [platelet count (PLT), mean platelet volume (MPV), platelet pressure product (PCT)], coagulation indices [prothrombin time (PT ), activated partial thromboplastin time (APTT)], serum inflammatory mediators [tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8), CXC chemokine ligand 10 (CXCL10), α-granule membrane glycoprotein (CD62P)] levels. Results The total clinical efficiency of the observation group was 96.49% (55/57) higher than that of the control group 83.93% (47/56, P < 0.05); the VAS and ODI scores of the observation group were lower than those of the control group and the JOA score was higher than that of the control group after 10 d of treatment (P < 0.05). After 10 d of treatment, PLT, MPV and PCT in the observation group were lower than those in the control group, and serum PT and APTT were higher than those in the control group (P < 0.05); after 10 d of treatment, serum TNF-α, IL-8, CXCL10 and CD62P levels in the observation group were lower than those in the control group (P < 0.05). Conclusion Extracorporeal shock wave is effective in treating patients with lumbar disc herniation, improving clinical symptoms, regulating platelet parameters and coagulation function, and relieving inflammatory reactions.