胶原酶溶盘术治疗腰椎间盘突出症的三种不同穿刺方法比较

Clinical study of treating lumbar disk herniation with collagenase Via three different punctural ways

目的比较观察三种不同穿刺方法注射胶原酶治疗腰椎间盘突出症(腰突症)的临床疗效及优缺点。方法将150例腰突症患者随机分为A组、B组和C组各50例,A组从小关节间隙(硬膜外腔前间隙)入路,B组经小关节内侧缘入路到侧隐窝,C组经椎板外切迹到侧隐窝,三组患者均注入胶原酶600U(3ml)。结果三种不同穿刺方法注射胶原酶治疗腰突症的疗效及不良反应均无统计学差异。结论经小关节内侧缘或椎板外切迹进路到侧隐窝的路径较长,穿刺及解剖位置复杂,操作技术有难度。而经小关节间隙(硬膜外腔侧入法)穿刺的路径较短,穿刺定位简单,是一种简便、易操作的有效方法。

Objective To compared the therapeutic effect and excellence, defect of three punctures of collagenase injection in treating lubar disk herniation （LDH） .Methods 150 patients with LDH were randomly divided into three groups （50 cases for each） .Lateral recessus puncture was carried out through joint clearance and collagenase injected in group A. Lateral recessus puncture was carrled out through inside edge of joint in group B,Via the lateral insisura of vertebral lamina in group C.AU patients were injected 600U （3ml） collagenase.Results The therapeutic effect and adverse reaction in three groups were not significantly different （P 〉 0.05） .Conclusion Puncturing through inside edge of joint or the lateral insisura of vertebral lamina is the lengthy way, the puncturing and anatomic position are complex, operating technique is difficult. But through joint clearance is the shortest way it can make the puncture more easy and effective. disk hemiation;Collagenase;Punctures