低温等离子髓核消融术与胶原酶溶解术治疗颈椎间盘突出症的对比研究  

COMPARISON STUDY OF THE EFFECTS OF LOW-TEMPERATURE PLASMA NUCLEOPLASTY AND COLLAGENASE CHEMONUCLEOLYSIS IN THE TREATMENT OF CERVICAL DISC HERNIATION

作　　者：张荣宜 王立奎[1] 朱本藩[1] 赵家贵[1] 陈家骅[1] ZHANG Rong-Yi;WANG Li-Kui;ZHU Ben-Fan;ZHAO Jia-Gui;CHEN Jia-Hua(Department of Pain Medicine,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院疼痛科,合肥230022

出　　处：《中国疼痛医学杂志》2018年第12期912-916,共5页Chinese Journal of Pain Medicine

基　　金：安徽省自然科学基金(1808085MH310);安徽医科大学第一附属医院博士科研基金(3101005001249)

摘　　要：目的:比较低温等离子髓核消融术(low-temperature plasma nucleoplasty)与胶原酶溶解术(collagenase chemonucleolysis, CNL)治疗颈椎间盘突出症(cervical disc herniation, CDH)的临床疗效。方法:130例颈椎间盘突出症病人随机分为两组(n=65):胶原酶溶解术治疗组(A组)和低温等离子髓核消融术治疗组(B组)。采用视觉模拟评分法(visual analogue scale, VAS)对病人的疼痛水平进行评价,用改良的MacNab标准行手术疗效评估,并分析两组病人术后住院日的差别。结果:两组病人术后1天、1周、1个月、3个月和6个月VAS评分均显著低于术前,差异有统计学意义(P <0.01);但与A组比较,B组术后1天和1周病人VAS评分较术前降低更为显著,差异有统计学意义(P <0.01)。B组术后住院日显著少于A组,差异有统计学意义(P<0.01)。术后6个月A组和B组治疗的优良率分别为86.2%(56/65例)和83.1%(54/65例),两组优良率无统计学差异(P> 0.05)。结论:低温等离子髓核消融术和胶原酶溶解术均能有效治疗颈椎间盘突出症,但术后1周内低温等离子髓核消融术更能有效缓解病人的疼痛。Objective:To compare the effects of low-temperature plasma nucleoplasty and collagenase chemonucleolysis(CNL)in the treatment of cervical disc herniation(CDH).Methods:One hundred and thirty patients with cervical disc herniation were randomly divided into group A and group B(n=65 each).Group A and B were treated by CNL and low-temperature plasma nucleoplasty respectively.Visual analogue scale(VAS)was used to evaluate the degree of pain and the modified MacNab criteria was used to evaluate the clinical efficacy.The average length of hospital stay after procedure were analyzed.Results:The VAS scores were significantly decreased(P<0.01)at 1st day,1 week,1 month,3 months and 6 months after treatment in both groups compared with pre-treatment.Compared with Goup A,VAS scores remarkably reduced in Group B at 1st day and 1 week afer treatment(P<0.01).The average length of hospital stay after treatment of group B were significantly less compared with group A(P<0.01).There was no significant difference about the excellent and good rate between group A with 86.2%(56/65 cases)and group B with 83.1%(54/65 cases)at 6 month after treatment(P>0.05).Conclusion:The low-temperature plasma nucleoplasty and CNL are both effective in the treatment of cervical disc herniation.The low-temperature plasma nucleoplasty could be more effective to alleviate the patient's pain at 1 week after procedure compared with CNL.

关 键 词：颈椎间盘突出症 低温等离子髓核消融术 胶原酶溶解术 

分 类 号：R687.3[医药卫生—骨科学]