经皮髓核摘除和压管穿刺注酶术治疗腰椎间盘突出症  

Therapy of the lumbar disc herniation by percutaneous lumbar discectomy and injection of collagenase after the duct being pressed

作　　者：黄彰[1] 梅宝珊[1] 苏家庆[1] 

机构地区：[1]安徽省合肥市第一人民医院,230061

出　　处：《中原医刊》2003年第1期1-3,共3页Central Plains Medical Journal

摘　　要：目的 :介绍经皮髓核摘除和压管穿刺注酶术治疗腰椎间盘突出症的方法并评价其手术疗效。方法 :对 2 0 0 1年 3月～ 6月收治的腰椎间盘突出症患者 ,选择 31例共 44个突出的椎间盘 ,采用经皮髓核摘除和压管穿刺注酶术进行治疗。其中L4～ 5椎间盘突出 8例 ,L5S1椎间盘突出 10例 ,L4～ 5和L5S1椎间盘均有突出 13例。术中采用经皮髓核部分摘除后 ,再压管以减小工作管与冠状面的夹角 ,利用长针刺入间盘后部切吸“盲区”的残余髓核 ,注射胶原酶。结果 :术后观察全部病例并评定疗效 ,优 2 2例 ,良 8例 ,可 1例 ,优良率为 97%。无血管神经损伤和椎间盘炎发生。目前尚未发现症状复发者。结论 :经皮髓核摘除和压管穿刺注酶术是经皮髓核摘除术和盘内化学溶核术的有机结合 ,扬长避短的用于治疗腰椎间盘突出症的微创技术 ,疗效满意 ,值得应用和推广。Objective We introduced a method to treat the lumbar disc hemiation by percutaneous lumbar discectomy and injection of collagenase after the duct being pressed ,and evaluated curative effect of this surgery.Methods We applied percutaneous lumbar discectomy and injection of collagease after the duct being pressed to treat 44 hemiated lumbar discs,which came from 31 patients who had been admitted for lumbar disc he miation from March 2001 to June 2001.There were 8 cases in L 4?5 10 cases in L 5S 1 13 caese in both L 4?5 and L 5S 1.In surgery,after percutaneous removal of part of intervertebral disc,we pressed the duct to decrease the angle between working duct and coronary plane and injected collagenase into the rest of nucleus pulposus by a long needle,which was inserted into'blind zone'from the posterior.Results We observed total patients after surgery and evaluated the effect.There were 22 excellent cases,8 good cases,1 general case;the excellent and good percentage was 97%.All patients with no vascular or neural injury or discitis.As so far we haven′t found recurrent case.Conclusion This method is a microinjury technique to treat the lumbar disc hemiation,which is combination of percutansous lumbar discectomy and chemonuclcolysis.It also has satisfied curative effect and is worth applying and carring out.

关 键 词：经皮髓核摘除术 压管穿刺注酶术 腰椎间盘突出症 压管穿刺 化学溶核术 疗效 手术适应证 

分 类 号：R687.3[医药卫生—骨科学]