川芎嗪、玻璃酸钠预防腰椎间盘突出术后硬膜外粘连的临床研究  

Clinical study on prevention of epidural adhesion using sodium hyaluronate and ligustrazine after lumbar intervertebral discectomy

作　　者：王锡阳[1] 李康华[1] 李雄[1] 胡建中[1] 张宏其[1] 廖前德[1] 朱勇[1] 龙文荣[1] 

机构地区：[1]中南大学湘雅医院脊柱外科,湖南长沙410008

出　　处：《中国现代医学杂志》2006年第13期2026-2028,共3页China Journal of Modern Medicine

摘　　要：目的探讨预防腰椎间盘突出术后硬膜外粘连的治疗方法。方法前瞻性研究,将该院2002年1月～2004年6月收治的腰椎间盘突出症手术治疗患者386例随机分为4组,98例行常规术式(A组),96例术中硬脊膜和神经根外涂抹川芎嗪(B组),96例术中涂抹玻璃酸钠(C组),96例术中涂抹玻璃酸钠和川芎嗪混合液(D组)。随访12～36个月,平均(17±5.4)个月,有效随访352例,以上各组分别为89例、85例、87例和91例。疗效采用日本骨科学会(JOA)下腰痛评分体系进行量化评分。结果术后2周疗效四组差异无显著性(P>0.05);术后3个月A组明显低于其他3组,差异有显著性(P<0.01),其他3组差异无显著性(P>0.05);术后6、12和24个月A组明显低于B和D组,差异有显著性(P<0.01),A组低于C组,差异有显著性(P<0.05);C组低于B和D组,差异有显著性(P<0.05);B组和D组差异无显著性(P>0.05)。结论玻璃酸钠和川芎嗪混合液能够有效地预防腰椎间盘突出术后硬膜外粘连。[Objective] In order to approach an effective method to prevent epidural adhesion post-discectomy. [Method] A perspective study, divided 386 lumbar intervertebral disc herniation cases into 4 groups randomly, which were admitted in our hospital from Jan, 2002 to Jun, 2004, all patients were operated. Blank group（A） was 98 cases, diseectomy regularly, while group B, C and D were 96 cases equally, applied ligustrazine, sodium hyaluronate, sodium hyaluronate and ligustrazine around epidural and nerve roots respectively. Followed up from 12 to 36 months, average （17±5.4） months, 352 patients were followed up effectively, group A, B, C and D was 89, 85, 87 and 91 respectively. The therapeutic effect was scored by the Japanese Orthopaedic Association＇s Evaluation System for Lower Back Pain Syndrome（JOA Score）. [Results] The curative effect of the four groups has no statistical significance after 2 weeks（P 〉0.05）. 3 months after disectomy, group A was lower significantly than those 3 groups（P 〈 0.01）, however, there were no significant difference in those 3 groups（P 〉0.05）. After 6, 12 and 24 months, group A was lower than group B and D significantly （P 〈0.01）and lower than group C （P 〈0.05）, group C was lower than group B and D（P 〈0.05）, while there was no statistical significance in group B and D（P 〉0.05）. [Conclusion] The mixed liquor of sodium hyaluronate and lignstrazine can prevent epidural adhesion after lumbar intervertebral discectomy effectively.

关 键 词：腰椎间盘摘除术 硬膜外粘连 川芎嗪 玻璃酸钠 

分 类 号：R682.13[医药卫生—骨科学]