腰硬联合针与腰穿针在腰椎间盘突出溶盘术中应用比较

Comparison of applications of lumbar-dural joint puncture needle and lumbar puncture needle in disc dissolving operation for intervertebral disc protrusion

目的观察腰硬联合针与7号8～10cm细针(腰穿针)在臭氧加胶原酶注射治疗腰椎间盘突出溶盘术中的应用比较。方法将60例腰椎间盘突出患者随机分为两组,A组在CT引导下采用腰硬联合针穿刺,侧隐窝入路注射臭氧加胶原酶溶盘(n=30);B组在CT引导下采用腰穿针穿刺,侧隐窝入路注射臭氧加胶原酶溶盘(n=30)。比较两组患者治疗前、治疗后第5天VAS变化、治疗后1～12个月总疗效和并发症发生率。结果两组治疗前、治疗后第5天VAS、治疗后1～12个月总疗效相比差异均无统计学意义(P>0.05),但A组并发症发生率明显低于B组(P<0.01)。结论腰硬联合针注射臭氧加胶原酶治疗腰椎间盘突出治疗前、治疗后5天VAS及1～12个月总疗效与腰穿针相似,但并发症发生率明显减少,安全性更高,值得推广。

Objective To observe the comparison of applications of lumbar-dural joint puncture needle and 7# lumbar puncture needle（8-10cm）in disc dissolving operation by injection of ozone plus collagenase for intervertebral disc protrusion.Methods Sixty patients of intervertebral disc protrusion were divided into two groups.Group A（N=30）were given disc dissolving operation composed by lumbar-dural joint puncture needle paracentesis with side-crypt route ozone plus collagenase injection under CT guidance.And Group B（N=30）received disc dissolving operation composed by lumbar puncture needle paracentesis with side-crypt route ozone plus collagenase injection under CT guidance.VAS changes before operation and 5th day post-treatment of the two groups were compared.So did gross effective rates and complication rates 1 to 12 months after treatment.Results VAS changes before operation and 5th day post-treatment of the two groups showed no statistic difference（P0.05）,neither did gross effective rates 1 to 12 months after treatment.Complication rates of Group A,however,were significantly lower than that of Group B（P0.01）.Conclusion For disc dissolving operation by ozone plus collagenase injection,VAS changes before operation and 5th day post-treatment and gross effective rates 1 to 12 months after treatment are similar,using either lumbar-dural joint puncture needle or lumbar puncture needle.Nevertheless,lumbar-dural joint puncture needle results obviously less complications,thus it has higher safety and is worth clinical extending.