臭氧与胶原酶盘内联合注射治疗腰椎间盘突出症的研究

目的研究臭氧与胶原酶盘内联合注射治疗腰椎间盘突出症。方法选择经保守治疗无效的腰椎间盘突出症患者191例，按就诊顺序将患者随机分为3组，I组为臭氧与胶原酶盘内联合注射，87例；Ⅱ组为臭氧盘内注射，65例；Ⅲ组为胶原酶盘内注射，39例，治疗后观察其效果及并发症。结果3组患者性别、年龄、病程、突出间隙、突出类型无统计学差异（P〉0.05）。治疗后并发症，I、Ⅱ、Ⅲ组分别为5．7％、6．1％、71．1％。Ⅲ组分别与I组与Ⅱ组相比差异有统计学意义（P〈0．05），其中疼痛加重率分别为2．3％、3．1％、61．5％，Ⅲ组注射后疼痛加重发生率分别与I组、Ⅱ组相比差异有统计学意义（P〈0．05）。全部患者，均于治疗6个月后进行随访，I、Ⅱ、Ⅲ组有效率分别为96．6％、90．7％、89．7％。优良率分别为85．1％、73．8％、74．4％。Ⅱ、Ⅲ组治疗后有效率及优良率相比无统计学差异（P〉0．05）。分别与I组治疗的有效率及优良率相比差异均有统计学意义（P〈0．05）。结论臭氧与胶原酶盘内联合注射治疗腰椎间盘突出症，效果优于单纯臭氧盘内注射及单纯胶原酶盘内注射，并发症少于单纯臭氧盘内注射及单纯胶原酶盘内注射，是一种较好的微创介入治疗方法。

Treatment of lumbar intervertebral disc herniation by ozone combined with collagenase injected into disc

Objective To observe the efficacy and complications of ozone combined with collage- nase injected into disc for treatment of lumbar intervertebral disc herniation and to compare that with ozone or collagenase single. Method One hundred and ninety one patients suffered from lumbar intervertebral disc herniation were sequentially divided into group I （treatment by ozone combined with collagenase, n = 87 ） , group Ⅱ（ by ozone single, n = 65 ） and group Ⅲ （ by collagenase single, n = 39 ）. All drugs were injected into intervertebral disc guided by computed tomography. Results There were no differences in sex, age, course of the disease and the types of herniation among patients in three groups （P 〉0.05 ）. At the sixth month of follow up after treatment, the effective rates were 96.6% ,90.7% and 89.7% and the rates of excellent and good were 85.1% ,73.8% and 74.4% respectively in group I , group Ⅱ and group Ⅲ. Complications happened in some patients in group I （5.7%） ,group Ⅱ（6.1%） and group Ⅲ（71.1%）. Conclusion Ozone combined with collagenase injected into disc for treatment of lumbar intervertebral disc herniation has much better efficacy and less complications than that with ozone or collagenase single.