胶原酶治疗腰椎间盘突出症的临床研究

目的 探索胶原酶不同途径和方法注射治疗腰椎间盘突出症的疗效与不良反应。方法 将胶原酶800U稀释成2ml在电视X光机监视下后路盘内或硬膜外注射，483例共分3组，A组盘内注射105例，硬膜外注射378例，其中B组单纯胶原酶142例，C组胶原酶和地塞米松联合注射236例。结果 在统计学上3组优良率无显著差异，总的优良率为86.5%，但各组的反应发生率有极其显著差异。结论 （1）硬膜外注射与椎间盘内注射疗效相同；（2）硬膜外注射比盘内疼痛反应轻且少，加用地塞米松疼痛反应更轻更少；（3）硬膜外注射对多椎间盘突出更适宜。

Treatment of lumbar disc herniation by collagenase

Objective To study the treatment of lumbar disc herniation with collagenase by different ways of injection.Methods 800 U collagenase were diluted in 2 ml,injected into the disc or the epidural space and monitored by television x-ray.483 patients were divided into 3 groups:group A of 105 cases received disc injection,group B of 142 cases received epidural injection,and group C of 236 also received epidural injection but of combined collagenase and dexamethasone.Results There were no statistically significant differences between the three groups in rates of excellent rseults,but the differences in pain reaction rate was significant.Total excellent rate was 86.5%.Conclusions (1) The curative effects of disc injection and epidural injection are identical.(2)Pain reaction of epidural injection is milder and less than that of disc injection,and the injection of dexamethasone has mildest and least pain reaction.(3)Epidural injection is suited for multiple disc herniation.