胶原酶治疗极外侧型腰椎间盘突出症的临床分析  

Clinical analysis of collagenase in the treatment of extreme lateral lumbar disc herniation

作　　者：谢燕斌[1] 陈平[1] 何伟[1] 杜佳繁 Xie Yanbin;Chen Ping;He Wei;Du Jiafan(Department of Pain,Mianyang Central Hospital,Sichuan 621000,China)

机构地区：[1]四川省绵阳市中心医院疼痛科,621000

出　　处：《山西医药杂志》2022年第3期251-254,共4页Shanxi Medical Journal

摘　　要：目的探析将胶原酶用于极外侧型腰椎间盘突出症患者治疗中的效果。方法选取2018年2月至2020年12月,就诊于我科的92例极外侧型腰椎间盘突出症患者作为研究对象,根据治疗方法的不同对92例患者进行分组,对照组和观察组各46例。对照组采用椎间孔镜手术治疗,观察组患者行CT引导下突出物内注射胶原酶髓核溶解术治疗,治疗前和治疗后3个月时直腿抬高的角度、腰椎间盘突出指数(IDH)、CT值、腰椎功能及患者治疗后3个月时的治疗效果为观察指标,对两种治疗方案的效果进行对比。结果2组患者治疗后3个月时直腿抬高的角度较对照组明显升高(P<0.05);观察组治疗后3个月时直腿抬高的角度较对照组治疗后3个月时明显更高(P<0.05)。2组患者治疗后3个月时的IDH较治疗前明显降低(P<0.05),CT值较治疗前明显升高(P<0.05);观察组患者治疗后3个月时的IDH明显更低(P<0.05),CT值明显更高(P<0.05)。观察组患者的治疗效果优良率较对照组明显升高(P<0.05)。2组患者治疗后3个月时腰椎功能评分明显降低(P<0.05),观察组患者治疗后3个月时的腰椎功能评分明显更低(P<0.05)。结论极外侧型腰间盘突出症患者实施胶原酶治疗,不仅疗效确切,还不改变患者原有解剖结果,其效果与手术治疗相近且创伤更小,适用于不耐受手术或不愿行手术治疗的极外侧型腰椎间盘突出症患者。Objective To explore the effect of collagenase in the treatment of extreme lateral lumbar disc herniation.Methods A total of 92 cases of extreme lateral lumbar disc herniation admitted to our hospital from February 2018 to December 2020 were selected as the research objects.According to the different treatment methods,these cases of patients were divided into control group(n=46)cases and observation group(n=46).The patients in control group were treated with transforaminal endoscopic surgery,and the ones in observation group were treated with collagenase injection into the protrusion under CT guidance.The straight leg elevation angle,lumbar disc herniation index(IDH),CT value,lumbar function and the treatment effect were observed as the indexes before and 3 months after treatment.The effects of the two treatment schemes were compared.Results The straight leg elevation angle of the two groups at 3 months after treatment was significantly higher than that of the control group(P<0.05).The straight leg elevation angle of the observation group at 3 months after treatment was significantly higher than that of the control group at 3 months after treatment(P<0.05).The IDH of the two groups at 3 months after treatment was significantly lower than that before treatment(P<0.05),and the CT value was significantly higher than that before treatment(P<0.05).The IDH of the observation group at 3 months after treatment was significantly lower(P<0.05),and the CT value was significantly higher(P<0.05).The excellent and good rate of the observation group was significantly higher than that of the control group(P<0.05).The lumbar function score of the two groups was significantly lower at 3 months after treatment(P<0.05),and the lumbar function score of the observation group was significantly lower than that of the control group at 3 months after treatment(P<0.05).Conclusion Collagenase therapy for patients with extreme lateral lumbar disc herniation can not only effectively improve the treatment effect,but also improve the lumbar fun

关 键 词：椎间盘移位 胶原酶类 治疗结果 极外侧型腰椎间盘突出症 

分 类 号：R681.53[医药卫生—骨科学]