C型臂引导下经皮盘内注射胶原酶联合盘外靶点注射镇痛复合液和胶原酶治疗腰椎间盘重度突出症的疗效  

Efficacy of intra-disc collagenase injection combined with epidural compound analgesic solution and collagenase extra-disc target injection under C-arm guidance in the treatment of lumbar disc herniation

作　　者：陈会平 李强 伍世亮 郑小平 张平会 徐淼 刘尊鸿 杨庆红 万金华 

机构地区：[1]荆门市第二人民医院疼痛科,湖北省荆门市448000 [2]湖北省中山医院省疼痛治疗中心,430000

出　　处：《实用疼痛学杂志》2015年第6期406-410,共5页Pain Clinic Journal

摘　　要：目的 观察C型臂引导下经皮穿刺椎间盘突出靶点内注射胶原酶联合硬膜外前间隙靶点外缘注射镇痛复合液和胶原酶治疗重度并部分脱出腰椎间盘突出症的临床效果.方法 腰椎间盘突出症患者30例,随机分为A、B组,每组15例.A组在C型臂引导下经皮穿刺椎间盘内注射胶原酶400 U后,在硬膜外前间隙突出靶点外注入镇痛复合液3 ml;B组在A组基础上突出靶点盘外再注入胶原酶800U.治疗效果用视觉模拟评分法（VAS）与生活质量评分法评价.结果 两组在术后1、2、6、12个月时VAS评分均较术前明显下降,差异有统计学意义（P＜0.05）,B组远期效果较A组疗效明显提高（P＜0.05）,生活质量亦显著改善,且B组优于A组（P＜0.05）.结论 在C型臂引导下经皮穿刺椎间盘突出靶点内注射胶原酶联合硬膜外前间隙靶点外缘注射镇痛复合液和胶原酶治疗腰椎间盘重度突出症是一种有效的方法.Objective To investigate the clinical effects of injecting collagenase into lumbar disc and injecting compound analgesic solution with collagenase into the extra-disc epidural space under the C-arm guidance in the treatment of lumbar disc herniation.Methods Thirty patients with lumbar intervertebral disc herniation were randomly divided into combination group （group A） and complex combination group （group B）.The patients in group A were injected 400 U collagenase into lumbar disc and compound analgesic solution into the epidural protuberance point, and in group B injected additionally 800 U collagenase into protuberance point on the basis of group A.The treatment effect was evaluated by VAS and life quality score.Results VAS declined in the two group at 1,2,6 and 12 months after the treatment, with statistical significance （P〈 0.05）.The effects in group B were better than those in group A （P〈 0.05）.The life quality score was significantly improved and it was better in group B than that in group A （P 〈 0.05）.Conclusion The treatment of lumbar intervertebral disc herniation with injecting collagenase into lumbar disc and injecting compound analgesic solution and collagenase into the extra-disc epidural space of target protuberance point under the C-arm guidance is effective.

关 键 词：胶原酶 腰椎间盘突出症 硬膜外前间隙 靶点注射 腰椎间盘脱出 

分 类 号：R681.530.5[医药卫生—骨科学]