经皮激光椎间盘减压术联合胶原酶靶点溶解术治疗腰椎间盘突出症的临床研究

[目的]观察在CT引导下经皮激光椎间盘减压术(Percutaneous Laser Disk Decompressuer,PLDD)联合胶原酶靶点溶解术治疗腰椎间盘突出症的临床效果及其安全性,并与单纯PLDD治疗效果相比较。[方法]将2006年10月至2010年10月本研究选择的36例腰椎间盘突出症患者,分为PLDD治疗组16例和PLDD联合胶原酶靶点溶解术治疗组20例。两组均在CT定位下行微创介入治疗。比较两组患者治疗前、术后3d、术后1周、术后1月及术后2月的VAS评分和JOA评分、疼痛缓解50%时间、并发症发生率。所有数据统计均采用SPSS软件处理,统计方法采用t检验,以P<0.05判定为有显著性差异。[结果]PLDD组和PLDD+胶原酶靶点溶解术组两组治疗前、术后3d及术后1周的VAS评分、JOA评分、疼痛缓解50%的时间、并发症发生率相比均无显著性差异。两组术后1月和术后2月的VAS评分、JOA评分均有显著性差异。两组无并发症出现。[结论]PLDD和胶原酶靶点溶解术是治疗椎间盘突出症患者安全、有效的微创介入治疗方法;PLDD联合胶原酶靶点溶解术治疗腰椎间盘突出症的长期疗效(2月后)优于单纯的PLDD。

The Clinical Study of Percutaneous Laser Disc Decompression United Collagenase for Lumbar Disc Herniation

[ Objective ] To observe CT-guided percutaneous laser disc decompression（PLDD） united coUagenase target dissolution treatment of lumbar disc herniation, as compared with the simple PLDD. [Methods] The study population comprised 36 subjects from October 2006 to October 2010 in hospital. They consisted of 2 groups. PLDD group comprising 16 patients; PLDD united coUagenase dissolution treatment comprising 20 patients. Visual analogue scale （VAS） score and the Japanese Orthopaedics Association （JOA） score were used to evaluate the pre-therapy and the therapeutic effects at lth day, 3th day, 1th week, Ida month and 2nd month after operation, of which with improved rate〉50% was classified excellent and good rate. The SPSS software was used for all statistical analyses. T test was used to compare the study between 2 groups. Statistical significance was assumed when a null hypothesis could be rejected at P〉0.05. [Result] There was no difference in VAS score, JOA score, excellent and good rate, and complications between 2 groups pre-operation and post-operation, while difference in VAS score and JOA score among i th and 2nd months postoperation. [ Conclusion] PLDD united collagenase target dissolution treatment had been proved to be an effective and safe therapy for patients in lumbar disc herniation. There was no difference in short-term effect between groups; while PLDD united collagenase dissolution had much more high long-term effect than the simple PLDD.