胶原酶溶解术中调整造影剂分布对疗效的影响

THE CLINICAL EFFECT OF CHEMONUCLEOLYSIS BY ADJUSTING THE CONTRAST AGENT OMNIPAQUE IN THE TREATMENT OF LUMBAR DISC HERNINATION

目的:通过调整造影剂在腰椎间盘和突出物内分布,探讨提高胶原酶溶解术治疗椎间盘突出症临床疗效的方法。方法:将83例经腰椎CT或MRI确诊为腰椎间盘突出症的患者随机分成对照组和造影组,两组均在CT直视下经椎板间孔入路穿刺成功,针尖(靶点)位于突出椎间盘突出物内。对照组直接注射胶原酶;造影组注射碘海醇0.5ml,突出物显影完整后注射胶原酶;术后1周、3月、6月对两组患者进行随访。结果:造影组术后3个月、6个月有效率达90.48%、97.62%,造影组术后6月疗效优于对照组,有统计学意义。结论:胶原酶溶解术中调整造影剂分布可提高远期临床疗效。

Objective ： Chemonucleolysis by adjusting the contrast agent omnipaque in an attempt to improve the long term clinical effect.Methods ： 83 patients of lumbar disc herniation were divided randomly into two groups.The operations were carried out under CT guidance,and the target point was the disc prominence.The control group were not injected with contrast agent.In the contrast group,0.5ml Omnipaque contrast were injected in order to observe the contrast agent distribution in prominence.Adjusting the needle position until a full prominence is developed.After 1 week,3 months,6 months,patients is developed followed-up.Results ： The efficacy rate in the angiography group after three and six months were 90.5% and 97.6%,respectively.The effects of angiography group were significantly better than the control group after six months.Conclusion ： chemonucleolysis with adjustment of the distribution of contrast agents can improve clinical efficacy.