CT引导下胶原酶定向靶位注射治疗腰椎间盘突出症的研究

A clininal study of CT-guided collagenase directional target injection treatment to protrusion of intervertebral disc

目的:探讨CT引导下胶原酶定向靶位注射,治疗腰椎间盘突出症的疗效及可行性。方法:161例腰椎间盘突出症随机分为3组,Ⅰ组(治疗组)49例在CT引导下作定向靶位治疗,Ⅱ组58例在C型臂引导下注入消炎镇痛药物治疗,Ⅲ组54例C型臂引导下注射胶原酶治疗。记录3组的穿刺时间、治疗前后的VAS评分(0-10cm)及进行疗效评定。结果:失访23例,第Ⅰ组的穿刺时间明显少于第Ⅱ组和第Ⅲ组,第Ⅰ组的治愈率明显高于第Ⅱ组和第Ⅲ组,3组治疗前后VAS评分治疗前和治疗后3-7天对照差异显著(P<0.01),治疗后0.5-1年第Ⅰ组明显优于第Ⅱ组和第Ⅲ组。结论:CT引导下胶原酶定向靶位注射,治疗腰椎间盘突出症操作简便、安全准确、疗效确切,值得推广。

Objective： To explored the therapeutic effectiveness and feasibility of CT-guided collagenase directional target injection treatment in patients with protrusion of intervertebral disc. Methods ： 161 patients with protrusion of intervertebral disc were divided into three groups randomized. Group A （treated group） 49 patients were treatment in CT-guided used collagenase directional target injection. Group B 54 patients were treatment in C-type arm-guided used antiphologistic and analgesic drugs directional target injection. Group C 58 patients were treatment in C-type arm-guided used collagenase directional target injection. The three groups patient＇s puncture times , before and after treatment VAS pain scores and therapeutic effectiveness were records respectively. Results： The result showed that 23 patients were lost following-up. The puncture time of Group A was smaller than Group B and Group C obviously. The cure rate of Group A was higher than Group B and Group C. All three groups patient the VAS pain scores were compare the before of treatment and with after the treatment 3 days to 7 days have a obvious difference （ p〈0.010 ）. During the following-up six months to one year, the VAS pain scores in Group A were significantly lower than Group B or Group C. Conclusion： It is an effective and safe treatment that CT-guided collagenase directional target injection treatment in patients with protrusion of intervertebral disc.