经皮腰椎间盘髓核摘除术和胶原酶溶核术的疗效比较

目的　比较经皮腰椎间盘摘除术 (APLD)和胶原酶溶核术 (CCNL)对腰椎间盘突出症的治疗作用。方法　符合治疗标准的腰椎间盘突出症 2 34例 ,其中APLD组 118例 ,CCNL组 116例。两治疗组采用统一的病例选择标准 ,疗效判别标准和3个月以上的随访。经X线引导完成全部治疗过程。结果　APLD组有效率 89 8% ,无效率 10 2 % ;CCNL组有效率 78 4% ,无效率 2 1 6 % ,两治疗组的有效率和无效率有明显统计学差异 (P <0 0 5 )。结论　作者认为 :(1)APLD为包容性腰椎间盘突出症的首选治疗方法 ,但必须严格掌握禁忌证和适应证。 (2 )CCNL的盘外注射法其疗效低于APLD ,但具有简便迅速无创伤痛苦少的优点 ,而盘内注射法尚需作进一步研究

A Comparative Study about Curative Effect of Automated Percutaneous Lumbar Discectomy and Collagenase Chemonucleolysis

Objective Comparing curative effect of automated percutaneous lumbar discectomy (APLD) and collagenase chemonucleolysis(CCNL)to herniation of lumbar intervertebral disc.Methods Two hundred and thirtyfour patients were accorded with caring critera about herniation of lumbar intervertebral disc,of these,118 patients were treated by APLD and 116 patients were treated by CCNL with X-ray guidance.Two groups were used the same critera in selecting patients and judging curative effect and followed up beyond three months.Results There were 89 8% effective rate and 10 2% ineffective rate in APLD and 78 4% effective rate and 21 6% ineffective rate in CCNL.There was a significant difference statistically between APLD and CCNL(P<0 05).Conclusions (1)APLD was firstly selected for treating contained herniated lumbar discs but must strictly master indication.(2)The extradiscolysis of CCNL was less effective than APLD but had some advantage such as less pain,less injury,while intradiscolysis of CCNL need to be further studied.