CT引导靶位注射胶原酶治疗巨大型颈椎间盘突出症的研究  

A CLINICAL STUDY ON CT-GUIDED TARGET-INJECTION OF COLLAGENASE IN TREATMENT OF HUGE CERVICAL DISC HERNIATION

作　　者：刘丽[1] 吴云松[1] 刘庆 

机构地区：[1]四川省科学城医院疼痛科,绵阳621900 [2]西南医科大学附属中医院疼痛科,泸州642600

出　　处：《中国疼痛医学杂志》2017年第5期356-360,共5页Chinese Journal of Pain Medicine

摘　　要：目的:探讨经颈前外侧入路靶位注射高浓度低容量胶原酶治疗巨大型颈椎间盘突出症的临床疗效及安全性。方法:收集CT扫描颈椎间盘突出矢状径大于同节段椎管矢状径二分之一的巨大型颈椎间盘突出症病人共60人。均采用CT定位下经颈前外侧入路穿刺至颈椎间盘内,分次间断推注入0.2~0.3 ml胶原酶溶夜(含300~400 U胶原酶)。记录病人术后3天、7天、1个月及半年的视觉模拟量表评分(visual analogue scale,VAS),改良Macnab法评定病人术后1周,1个月,半年的疗效,术后突出物指数变化及不良情况。结果:术后3天、1周、1个月及6个月的VAS评分较术前显著减低(P<0.05)。改良Macnab法评定术后1周、1个月、半年的有效率分别为77.33%、90%、96.67%。术后半年突出缩小优良率为94.4%。结论:在CT定位下经颈前外侧入路靶位注入少容量高浓度胶原酶用于治疗巨大颈椎间盘突出症是可行的。Objective：To investigate the clinical efficacy and safety of high-concentration low-volume collagenase target-injection on huge cervical disc herniation, through cervical disc puncture via anterolateral cervical approach.Methods：As shown by CT scan, 60 patients with huge cervical disc herniation are included as research object, in whom huge cervical disc herniation has typical clinical manifestations of cervical disc herniation, The needle was advanced into the cervical disc, through CT-guided puncture via the anterolateral cervical approach, and 0.2-0.3 ml of collagenase solution （containing 300 ~ 400 U of collagenase） was injected intermittently in several portions. The visual analogue scale of the patients were recorded in 3 days, 7 days, 1 month, and 6 months after treatment. The comprehensive efficacies were assessed in after 1 week, 1 month, and half a year by the modified Macnab method. Calculated the reduction rate of projections by CT rescan were followed up in half a year after the procedure. The patients were observed for occurrences of adverse during and after treatment.Results：Compared with the VAS scores prior to the procedure, those in 3 days, in 1 week, 1 month, and 6 months after the procedure were decreased significantly （P 〈 0.05）. The postoperative 1 week, 1 month, and 6 months improvement in Macnab therapeutic rate were 77.33%,90%,96.67% respectively. By cervical CT rescan in half a year after the procedure, the good rate of protrusion minification was 94.4%.Conclusion： It is feasible for target-injection of high-concentration low-volume collagenase solution in treatment of huge cervical disc herniation, through CT-guided cervical disc puncture via anterolateral cervical approach.

关 键 词：胶原酶化学溶解术 巨大颈椎间盘突出症 CT引导 神经阻滞 

分 类 号：R681.5[医药卫生—骨科学]