单纯胶原酶与联合切吸治疗腰椎间盘突出症的疗效对比  

Comparison between the effects of simplex collagenase chemonucleolysis and its combination therapy with automated percutaneous lumbar discectomy on lumbar disc herniation

作　　者：肖建斌[1] 佘守章[1] 张本国[2] 胡志平[1] 

机构地区：[1]广州医学院附属广州市第一人民医院麻醉科疼痛中心,广东省广州市510180 [2]北京大学神经科学研究所,北京市100083

出　　处：《中国临床康复》2004年第20期3944-3945,i001,共3页Chinese Journal of Clinical Rehabilitation

基　　金：广东省卫生厅医学科研基金资助项目(A1999495)~~

摘　　要：目的:比较和评价两种方法治疗腰椎间盘突出症的疗效。方法:180例腰椎间盘突出症患者,根据治疗方法不同分为两组,每组90例。组Ⅰ采用单纯胶原酶溶盘术治疗,组Ⅱ采用经皮椎间盘切吸联合胶原酶溶盘术。比较两组的治疗效果。结果:两组患者年龄及治疗前的症状与体征无明显统计学差异。治疗后1周组Ⅰ、组Ⅱ的疗效优良率分别为67%,91%,术后随访3个月～1年,于3,6,12个月时的优良率组Ⅰ分别为69%,68%和68%,组Ⅱ为90%,94%和94%,两组疗效于治疗后1周和3个月时的优良率差异均有显著性意义(P<0.05)。结论:经皮椎间盘切吸联合胶原酶盘外溶解疗法治疗腰椎间盘突出症的近期和远期疗效均明显优于单纯胶原酶溶盘术,且可降低单纯胶原酶盘内注射溶盘术的不良反应发生率。AIM:To compare and evaluate the effects of two different therapies on lumbar disc herniation(LDH). METHODS:Totally 180 patients with LDH were randomly divided into two groups according different therapies.One group was treated by simplex collagenase chemonucleolysis(groupⅠ,n=90) and the other group was treated by automated percutaneous lumbar discectomy(APLD) combined with extradiscolysis of collagenase chemonucleolysis(groupⅡ,n=90).The effects of the two therapies in the two groups were evaluated. RESULTS:There were no significant differences in age,preoperative symptoms and signs between the two groups.The good rate was 67% and 91% in groupⅠ andⅡ respectively,69%, 68%,68% in group Ⅰ and 90%,68%,68% in group Ⅱ after 3 ,6 and 12 month follow up.There were significant differences in the good rate between the two groups a week and 3 months after treatment(P< 0.05). CONCLUSION:APLD combined with collagenase chemonucleolysis(extradiscolysis) has more short term and long term effects than simplex collage chemonucleolysis in treating LDH,and can reduce the rate of complications caused by intradiscolysis of simplex collagenase chemonucleolysis.

关 键 词：椎间盘移位 椎间盘化学松解术 椎间盘切除术 胶原酶类 

分 类 号：R681.5[医药卫生—骨科学]