椎间孔镜与靶点射频治疗腰椎间盘突出症疗效比较  

COMPARATIVE CLINICAL EFFICACY BETWEEN PERCUTANEOUS INTRADISCAL RADIOFREQUENCY THERMOCOAGULATION COMBINED WITH COLLAGENASE CHEMONUCLEOLYSIS AND PERCUTANEOUS ENDOSCOPIC INTERLAMINAR DISCECTOMY IN TREATING LUMBAR DISC HERNIATION

作　　者：郭瑞宏[1] 张然[2] 赵建民[1] 张瑜[1] 樊碧发[3] 

机构地区：[1]首都医科大学密云教学医院麻醉疼痛科,北京101500 [2]北京市顺义区空港医院疼痛科,北京101318 [3]卫计委中日友好医院疼痛科,北京100029

出　　处：《中国疼痛医学杂志》2015年第7期521-523,528,共4页Chinese Journal of Pain Medicine

摘　　要：目的:探讨椎间孔镜技术和靶点射频联合胶原酶化学溶解术治疗腰椎间盘突出症的效果比较。方法:60例腰椎间盘突出症患者分为两组,每组30例,A组用靶点射频联合胶原酶化学溶解术,B组用椎间孔镜技术。记录术前和术后即刻、术后3个月、6个月、12个月的疼痛视觉模拟评分(visual analog score,VAS),采用Mac Nab标准评定疗效。结果:两组患者的疼痛均得到明显改善,A组VAS评分从术前的(7.25±1.56)分下降到12个月的(1.93±0.39)分,B组VAS评分从术前的(7.35±1.58)分下降到12个月的(1.76±0.27)分,两组术后VAS评分均较术前显著降低(P<0.05);B组在术后即刻、术后3个月和术后6个月VAS评分低于A组(P<0.05)。术后12个月A组优良率83.33%,B组优良率89.67%,B组优良率高于A组,但是统计学没有显著意义(P>0.05)。结论:治疗腰椎间盘突出症椎间孔镜技术6个月内疼痛症状改善优于靶点射频联合胶原酶化学溶解术。Objective： To compare the clinical outcomes between PELD（Percutaneous Endoscopic Lumber Discectomy） and target radiofrequency combined with collagenase chemonucleolysis in treating lumbar disc herniation. Methods： 60 patients with lumbar disc herniation were divided into two groups（group A： Target radiofrequency combined with collagenase chemonucleolysis, group B, PELD） and 30 patients were enrolled in each group. Visual Analogue Scale（VAS） was used at preoperation and immediately, 3-months, 6-months, and 12-months after the operation to evaluate analgesic effect. Therapeutic effect was evaluated by Standard Macnab.Results： The clinical pain symptoms of two groups were relieved obviously at postoperation. In group A, the VAS, which was 7.25±1.56 before operation was significantly decreased to 1.93±0.39 at 12-months after operation. In group B, the VAS value before operation was 7.35±1.58 and decreased to 1.76±0.27 at 12-months after operation. Compared to group A, the VAS scores of group B were significantly lower（P〈 0.05） immediately, at 3-months and 6-months. after operation. The excellent and good rate at 12-months after operation seem to be higher in group B（gourp A： 83.33%, group B： 89.67%）, but this difference failed to reach statistical significance（P〉 0.05）. Conclusion： PELD technique is superior to target radiofrequency combined with collagenase chemonucleolysis at pain management within 6 months after treating lumbar disc herniation.

关 键 词：腰椎间盘突出症 椎间孔镜 靶点射频联合胶原酶化学溶解术 

分 类 号：R687.3[医药卫生—骨科学]