硬膜外侧前间隙置管注射胶原酶对腰椎间盘突出症的康复效果

Rehabilitation Efficacy of Collagenase Injection into the Lateral and Anterior Epidural Space by Intubation under CT's Intervention for Treatment of Lumbar Disc Prolapse

目的:研究CT介入下硬膜外侧前间隙置管注射胶原酶治疗腰椎间盘突出症(LDP)的康复疗效。方法:LDP患者240例,随机分为3组各80例,CT介入下,A、B组采用硬膜外侧前间隙置管注射胶原酶,B组于注射后第3天再从硬膜外导管注入消炎镇痛液;C组于下侧隐窝胶原酶注射。结果:痊愈显效率在治疗后15 d和6个月时A、B、C 3组分别为36.3%、61.3%、37.5%和61.3%、85.0%和60.0%,B组均显著优于A、C组(均P<0.01)。3组中痊愈显效患者1和2年复发率比较,差异无显著性意义。结论:CT介入下,硬膜外侧前间隙置管注射胶原酶与隐窝注射胶原酶治疗LDP的疗效比较差别无显著性意义,但前者更加安全,且在术后可方便硬膜外阻滞治疗而显著提高疗效。

Objective： To study the rehabilitation efficacy of collagenase injection into the lateral and anterior epidural space by intubation under CT＇s intervention for treatment of lumbar disc prolapse （LDP）. Methods： A total of 240 cases of LDP were divided into 3 groups at random （n = 80 in each group）. Under CT＇s intervention, in groups A and B, collagenase was injected into the lateral and anterior epidural space by intubation. On the group B, C 3 days later, dephlogisticate and analgesia liquor were injected via the epidural tube in group B. In group C, collagenase was injected into lateral recess. Resuits： Recovery and excellence rate in groups A, B and C was 36.3%, 61.3% and 37.5% respectively at 15th day after treatment. The effects in group B were significantly superior to those in group A and C （both P〈0.01）. And after 6 months, the rate in the 3 groups was 61.3%, 85.0% and 60.0% respectively. The effects in group B were obviously superior to those in groups A and C （both P〈0. 01）. There was no significant difference in one- and two-year recurrent rate in the cured patients among the three groups. Conclusion： Therapeutic effects of injection of collagenase into the lateral and anterior epidural space by intubation or into lateral recess were identical, but the former is more safe, and can improve curative effects by epidural block after operation.