硬膜外腔注射胶原酶治疗腰椎间盘突出症影响疗效的相关因素分析  

Related factors influencing the effect of epidural injection with collagenase on lumbar disc herniation

作　　者：汪军民[1] 朱珊珊[1] 喻传兵[1] 聂章宪[1] 

机构地区：[1]武汉大学人民医院康复科,湖北省武汉市430060

出　　处：《中国临床康复》2004年第32期7106-7107,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨X射线监视下硬膜外腔注射胶原酶治疗腰椎间盘突出症影响疗效的相关因素。方法:根据椎间盘突出的大小及突出类型和是否伴有椎管狭窄以及置管位置等将120例患者分组进行影响因素分析,通过复诊和电话询问,在术后1周、3个月、1年分别评定疗效。结果:椎间盘突出大小对疗效影响不明显(P>0.05);术后各时期突出型较膨出型疗效好犤μ分别为2.27(1周),2.15(3个月),1.97(1年),P<0.05犦;不同时期非椎管狭窄组疗效均好于椎管狭窄组犤μ=2.05(1周),μ=3.05(3个月),μ=3.25(1年),P<0.01犦;术后1周硬膜外前间隙组较后间隙组疗效好(μ=2.13,P<0.05),3个月和1年后两组无明显差别。结论:椎管狭窄和椎间盘膨出及药液注射部位是影响硬膜外腔注射胶原酶治疗腰椎间盘突出症疗效的主要因素。AIM:To probe into the related factors that influenced the effect of epidural injection of collagenase in patients with lumbar disc herniation under the observation of X ray. METHODS:The analysis of related factors in 120 patients were carried out and they were divided in terms of the size,the type,having spinal stenosis or not,and the position of canal.Assessment was made after one week,three months and one year by return visit and interrogation with telephone. RESULTS:The effect was not influenced by the size of lumbar disc herniation(P >0.05).The protruded disc got better effect than bulge disc at different periods postoperatively, μwas 2.27(one week),2.15(three months),1.97(one year),respectively(P< 0.05).The effect in patients without spinal stenosis was better than that in patients with spinal stenosis at different periods[μ=2.05(one week),μ=3.05(three months),μ=3.25(one year),P< 0.01].The effect of anterior epidural space group was better than that of the posterior epidural space group one week after operation(μ=2.13,P< 0.05),and there was no significant difference between the two groups at three months and one year. CONCLUSION:The stenosis,large herniation and the position of injection are the main factors that influence the effect of epidural injection of collagenase treating patients with lumbar disc herniation.

关 键 词：腰椎间盘移位 胶原酶类 椎间盘化学松解术 注射 硬膜外腔 

分 类 号：R681.5[医药卫生—骨科学]