臭氧盘内注射术联合胶原酶盘外溶解术治疗突出型腰椎间盘突出症的多中心应用观察  

Intradiscal Injection of O3 Combined with Epidural Injection of Collagenase for Treatment of Prominent Lumbar Disc Herniation： A Multicentral Application Observation

作　　者：张洪新[1] 陈岚[1] 王珩[1] 马锌明 陈士新 彭建明 张武平 钱学江[6] 王玉贤 冉宪章 李波 窦建明 贺朝 

机构地区：[1]第四军医大学唐都医院介入放射科,陕西西安710038 [2]新疆昌吉市第二人民医院软伤科 [3]陕西省汉中市3201医院放射科 [4]陕西省汉中市勉县医院放射科 [5]陕西省铜川市第二人民医院放射科 [6]解放军89医院放射科 [7]甘肃省永昌县医院放射科 [8]河南省温县医院放射科 [9]陕西省宝鸡市中医院介入科 [10]青海省海西州地区医院放射科 [11]陕西省第二纺织医院放射科

出　　处：《实用放射学杂志》2009年第3期396-400,共5页Journal of Practical Radiology

基　　金：基金项目：全军“十五”基金面上项目（编号：01Q124）.

摘　　要：目的探讨经皮穿刺臭氧盘内注射联合胶原酶盘外溶解术治疗突出型腰椎间盘突出症的疗效及安全性。方法对行臭氧盘内注射术加联合胶原酶盘外溶解术、资料完整的腰椎间盘突出症的541例病例进行随访观察,随访2～3个月者（近期）541例,4～12个月者（中期）312例,13～18个月者（远期）115例,按统一的疗效标准评价臭氧盘内注射联合胶原酶盘外溶解术的近、中、远期疗效并与有关多中心单位单纯行胶原酶盘外溶解术疗效进行对比。结果所选病例近期、中期、远期有效率分别为95.9%（519/541）、90.7%（283/312）、87.0%（100/115）;2种方法联合应用,突出的髓核有明显的不同程度的回缩,平均缩小30.5%;单纯行胶原酶溶解术近期、中期、远期有效率分别为89.5%、82.4%、80.4%。结论臭氧盘内注射联合胶原酶盘外溶解术治疗腰椎间盘突出症的疗效优于单纯胶原酶溶解术。Objective To investigate the curative effect and safety of percutaneous intradisc injection of Oa combined with epidural injection of collagenase for treatment of prominent lumbar disc herniation. Methods 541 patients with lumbar disc herniation received the treatment of intradiscal injection of 03 combined with epidural injection of collagenase. All cases were followed up for 2 to 3 months （short-term）, 312 for 4 to 12 months （medium-term） and 115 for 13 to 18 months （long-term）. The short-term, medium-term and long-term curative effects of intradiscal injection of O3 combined with epidural injection of collagenase were evaluated with unified curative criteria, and compared with the curative effect of simple collagenase chemonucleolvsis. Results The short-term, medium-term and long term effective rate of chosen cases were 95.9G （519/541）, 90.7% （283/312） and 87.0% （100/115）, respectively , and herniated nucleus pulposus were obvious shrinkaged in different degrees with mean shrink 30. 5% . The short-term , medium-term and long-term effective rate of simple collagenase chemonucleolvsis were 89.5% , 82.4% and 80. 4%, respectively. Conclusion The curative effect in treating lumbar disc herniation with intradiscal injection of O3 combined with epidural injection of collagenase is superior to simple collagenase chemonucleolvsis.

关 键 词：腰椎 椎间盘突出症 介入放射学 

分 类 号：R681.53[医药卫生—骨科学] R815[医药卫生—外科学]