螺旋CT引导下注射臭氧及联合应用胶原酶治疗腰椎间盘突出症疗效对比观察

Comparative study of curative effect of lumbar disk herniation with injection of ozone and combined collagenase with CT guiding

目的比较螺旋CT引导下经皮穿刺注射臭氧及联合应用胶原酶治疗腰椎间盘突出症的疗效差异及影像学评价作用。方法搜集整理120例经临床和CT/MRI诊断为腰椎间盘突出症,于螺旋CT机引导下经皮穿刺注射臭氧及联合应用胶原酶治疗的患者资料。分为两组,一组为单纯注射臭氧,一组为注射臭氧加注射胶原酶。对术后临床及影像学进行3～6个月近期、4～12个中期、13～36个月远期随访及对比。结果全部患者术中定位准确,穿刺成功率100﹪,60例单纯组和60例联合组近期、中期、远期疗效优良率分别为:90.0%、85.0%、76.7%;93.3%、92.0%、87.7%。25例单纯组和25例联合组CT/MRI近期、中期、远期随访有效率分别为:86.0%、88.0%、74.0%;90.0%、87.0%、85.0%。结论螺旋CT引导下经皮穿刺注射臭氧及联合应用胶原酶治疗腰椎间盘突出症是一种安全有效的方法,联合应用胶原酶治疗效果更佳,远期效果不如近中期效果,被高估。影像随访具有客观性和必要性。

Objective To evaluate the therapeutic results of oxygen - ozone combined collagenase injection for the treatment of lumbar disc herniation under spiral CT guidance compared with oxygen - ozone injection and clinical significance of spiral CT. Methods 120 cases of lumbar disk herniation diagnosed by clinic and CT/MRI were divided into two groups, one group was treated with the injection of oxygen - ozone combined with collagenase, the other group was treated with the injection of oxygen - ozone and contrast the postoperative clinic and imaging in short term of 3-6 months, the middle of g-12months, long-term of 13-36 months. Results All patients were accurately located during the operation, puncture success rate was 100%. Curative effect rate of the best and good for the short term ,the middle and long-term in 60 cases of simple group and 60 cases of combined group were 90.0%,85.0%,76.7%; 93.3%,92.0%,87.7%,respectively.The effective rate of follow-up with CT/MRI for the short term, the middle and long-term in 25 cases of simple group and 25 cases of combined group were 86.0%,88.0%,74.0% ; 90.0%,87.0%,85.0%,respectively. Conclusion It is a safe and effective method that percutaneous injection of ozone and comhined collagenase under spiral CT guidance for treatment of lumbar disk herniation. The combination of the oxygen - ozone with collagenase shows more significant. Imaging follow-up is necessary.