胶原酶化学溶解术治疗巨大型腰椎间盘突出症的临床疗效和影响因素分析

Analysis of clinical effects and influencing factors of collagenase chemonucleolysis in the treatment of huge lumbar disc herniation

目的探讨胶原酶化学溶解术(CCNL)治疗巨大型腰椎间盘突出症(HLDH)的疗效并分析其影响因素。方法回顾性分析2018年1月至2020年12月于空军军医大学唐都医院行CCNL的159例HLDH患者的临床资料。根据术后两年的治疗效果分为有效组(n=131)与无效组(n=28),进行单因素及多因素分析。结果术后两年,159例HLDH患者总优良率为82.4%。单因素分析结果显示患者年龄、术前腿部视觉模拟评分(VAS)、突出节段在两组间存在统计学差异(P<0.05)。多因素回归显示年龄和术前腿部VAS是影响HLDH治疗效果的独立因素。结论CCNL可有效治疗HLDH,高龄和术前腿部低VAS是疗效不佳的主要影响因素。

Objective To investigate the effects of collagenase chemonucleolysis(CCNL)on huge lumbar disc herniation(HLDH)and analyze its influencing factors.Methods The clinical data of 159 HLDH patients who underwent CCNL in Tangdu Hospital,Air Force Medical University from January 2018 to December 2020 were retrospectively analyzed.According to the treatment effect two years after surgery,the patients were divided into effective group(n=131)and ineffective group(n=28),and univariate and multivariate analyses were performed.Results Two years after surgery,the overall excellent rate was 82.4%in 159 HLDH patients.Univariate analysis showed statistical differences in age,preoperative Visual Analogue Scale(VAS)of legs and segments of herniation between the two groups(P<0.05).Multivariate regression showed that age and preoperative VAS of legs were independent factors affecting the efficacy of HLDH.Conclusion CCNL is an effective treatment for HLDH,and older age and lower preoperative VAS of legs are the main influencing factors for poor efficacy.