显微内窥镜下椎间盘切除术及其与胶原酶溶核术联合治疗腰椎间盘突出症的疗效比较

Comparison of the clinical effect between single microendoscopic discectomy and its combining with collagenase chemonucleolysis for treatment of lumbar disc herniation

目的:比较显微内窥镜下椎间盘除术(MED)及MED与胶原酶溶核术(CCNL)联合应用治疗腰椎间盘突出症的临床疗效。方法:120例腰椎间盘突出症患者中,60例单纯行MED治疗(MED组),另60例在行MED的基础上向椎间盘内注射胶原酶600U(MED+CCNL组)。术后观察并分析两组的疗效及并发症。结果:两组均顺利完成手术,未发生并发症。术后全部病例随访6～48个月,按照MacNab标准评定,MED组有效率为83.3%,MED+CCNL组为95%,后者明显高于前者(P<0.05)。结论:MED与CCNL联合治疗腰椎间盘突出症较单纯MED治疗具有更好的疗效。

Objective：To study the clinical effect in the treatment of lumbar disc herniation with microendoscopic discectomy（MED） and MED combining with collagenase chemonucleolysis（CCNL）.Method： 120 patients with lumbar disc herniation were divided into two groups and half of them were and treated by single MED （MED group） or MED combined with CNLL（MED＋CNLL group）.MED procedures were performed with conventional ways,and following MED 600U of collagenase were injected into the lumbar disc.The efficiency anti complications of all cases were investigated after operation.Result：All cases were followed up for 6-48 months,according to MacNab evaluation criterion,the rate of efficency：single MED group was 83.3% anti MED＋CNLL group was 95%,the latter was significantly higher than the former （P〈0.05）.Conclusion：MED combined with CCNL is more effective in the treatment of lumbar disc herniation with wide clinical indications and quick recovery.