CT引导椎间盘内、外联合注射胶原酶-臭氧治疗腰椎间盘突出合并I°腰椎滑脱症的临床疗效与安全性  

Clinical efficacy and safety of intradiscal injection with collagenase and oxgen-ozone gas mixture to treat lumbar disc herniation in patients with grade I degenerative spondylolisthesis

作　　者：刘明红[1] 鲁显福[1] 陈家骅[1] 

机构地区：[1]安徽医科大学第一临床学院一附院麻醉科,合肥230022

出　　处：《国际麻醉学与复苏杂志》2013年第3期234-238,252,共6页International Journal of Anesthesiology and Resuscitation

基　　金：国家自然科学基金项目（30972834,81100813）;江苏省教育厅省级重点实验室开放课题项目（KJS1101）

摘　　要：目的分析cT引导下联合注射胶原酶和臭氧治疗腰椎间盘突出症合并I°腰椎滑脱症的临床疗效及安全性。方法对49例腰椎间盘突出合并I°腰椎滑脱的患者采用联合注射胶原酶和臭氧溶盘术治疗，通过比较治疗前、后1周、6个月随访时疼痛视觉模拟评分（visualanaloguescale／score，VAS）、止痛药使用情况及滑脱椎体位移距离，并采用改良Macnab法对术后1周、6个月进行疗效评定。结果术后1周、6个月患者VAS评分及止痛药使用评分明显下降，与术前比较差异均有统计学意义（P〈0．05）；滑脱椎体移位距离术后l周、6个月与术前比较差异均无统计学意义（P〈0.05）；术后7d（近期疗效）与术后6月（远期疗效）比较，总体有效率分别为85．71％和87．76％，差异无统计学意义（P〉0．05）；优良率分别为65．31％和71．42％，差异有统计学意义（P〈0．05）。未见严重副作用与并发症发生。结论联合注射臭氧和胶原酶治疗腰椎间盘突出合并I°腰椎滑脱取得了较理想的临床疗效，可以明显改善患者疼痛，对滑脱椎体稳定性无影响而根性症状即刻改善明显，是一种较安全的微创治疗方法。Objective To analyze the clinical efficacy and safety of collagenase and oxygen-ozone intradiscal injection for the treatment of lumbar disc herniation in patients with Grade I degenerative spondylolisthesis. Methods Forty-nine patients who suffered lumbar disc herniation with grade I spondylolysis were therapeutically cured by the intervertebral disc injection of eollagenase and oxygen-ozone under the guidance of CT. Clinical effects were evaluated by observing the changes of visual analogues scales （ VAS ）, the condition of taking painkillers and the distance of the sliding vertebrae and by using modified Macnab method on postoperative day and at final follow-up （6 months after surgery）. Results Compared with preoperative clinical data, the VAS score and score of taking painkillers both dropped sharply, which reflected a significant difference compared to the previous data by statistical method （P〈0.05）. At the same time, the distance of the sliding vertebrae had no significant transform during the whole observation period. 7 days and 6 months after surgery, the efficience rate of treatment that we evaluated by using modified Macnab was 85.71% and 87.76% respectively. There were no statistical significance between the two time point （P〉0.05）. However there was significant difference to compare the excellence rate between the two time point as it was 65.31% and 71.42% respectively （P〈0.05）. There were no serious postoperative complications or side effects in all the patients. Conclusions It is very effective clinically to get intradiscal injection of combined collagenase and oxygen-ozone guided by CT for the treatment of lumbar disc herniation in patients with Grade I degenerative spondylolisthesis as radicular symptoms were remarkably improved in most patients immediately after surgery. Meanwhile it can relieve painfulness of the patient and has no influence of sliding vertebrae, which means it is a safe, effective and minimally invasive method for treatment of lumbar disc herniation i

关 键 词：腰椎间盘突出 腰椎滑脱 胶原酶 臭氧 CT引导 

分 类 号：R687.3[医药卫生—骨科学]