胶原酶突出物内外联合注射与盘外注射治疗腰椎间盘突出症的疗效比较

目的探讨胶原酶突出物内外联合注射与盘外注射治疗腰椎间盘突出症的疗效。方法将121例L4～5或L5S1椎间盘突出症患者随机分为3组。A组62例,行胶原酶突出物内外联合注射治疗:B组31例,行经骶裂孔硬脊膜囊前置管胶原酶注射术治疗;C组28例,行椎间孔硬膜外胶原酶注射治疗。治疗后3个月随访,行CT复查。结果A组突出物溶解率93.3%,优良率93.2%;B组突出物溶解率20%,优良率54.8%;C组突出物溶解率18.1%,优良率57.1%。A组突出物溶解率、优良率与B组和C组比较,有显著性差异(P<0.05)。结论突出物内外联合注射胶原酶治疗腰椎间盘突出症,其突出物的溶解率和疗效均明显高于另外2种治疗方法,值得推广应用。

THE EFFECTS OF COMBINED INJECTION AND EXTERIOR INJECTION OF COLLAGENASE IN TREATING PROLAPSE OF LUMBAR INTERVERTEBRAL DISC

Objective To explore the curative effects and the solution rates of protuberance by using the com-bined injection and exterior injection of collagenase in treating lumbar intervertebral disc protrusion(LIDP).Methods1211 cases were randomly divided into Group A,Group B and Group C.62 cases in Group A were treated with interior and exterior injections of collagenase.31 cases in Group B were treated with injection of collagenase by placing tubes before the dural sacs through sacural hiatus.28 cases in Group C received extradural injections of collagenase through intervertebral foramen.The three groups all got 3 months of follow-up sur-veys and CT re-examinations were made in 51 cases.ResultsThe solution rates and effective rates of 93.3% and 93.2% in Group A,20% and 54.8% in Group B and 18.1% and 57.1% in Group C respectively.There existed significant difference in solution rate,and effective rates between the three groups(P<0.05).Conclu-sionThe combined use of interior and exterior injection of collagenase in treating LIDP can produce good curative effect and deserves to be widely used clinically.