经皮穿刺髓核成形术和胶原酶溶核术(盘外法注射)的疗效比较

A Comparative Study about Curative Effect of Nucleoplasty and Collagenase Chemonucleolysis

目的:比较经皮穿刺髓核成形术(Nucleoplasty)和胶原酶溶核术(CCNL)对腰椎间盘突出症的治疗作用。方法:符合治疗标准的腰椎间盘突出症90例,其中Nucleoplasty组42例,CCNL组48例,两治疗组采用统一的病例选择标准,疗效判别标准在手术后1个月和3个月两时段进行随访。结果:Nucleoplasty组1个月有效率81.0％,无效率19.0％;3个月有效率88.1％,无效率11.9％;CCNL组1个月有效率54.2％,无效率45.8％;3个月有效率83.3％,无效率16.7％;Nucleoplasty组,两时段疗效无明显统计学差异(0.5>P>0.25);CCNL组两时段疗效有明显统计学差异(P<0.05);3个月时两治疗组的有效率和无效率无明显统计学差异(P>0.10)。结论:作者认为①上诉两种方法均确实有效并具有创伤小,出血少,脊柱力学结构完整等优点。②Nucleoplasty术减低椎间盘内压较CCNL更为迅速。

Objective: To compare curative effect of nucleoplasty and collagenase chemonucleolysis to lumbar intervertebral disc herniation. Methods: Ninety patients were accorded with caring critera about lumbar intervertebral disc herniation, this 42 patients were treated by nucleoplasty and 48 patients were treated by CCNL. Two groups were used the same critera in selecting patients and judging curative effect and follow up one month and three months later after operation. Results: One month after operation, there were 81.0% effective rate, 19.0% ineffective rate in nucleoplasty, 54.2% effective rate and 45.8% ineffective rate in CCNL; Three months after operation, there were 88.1% effective rate, 11.9% ineffective rate in nucleoplasty, 83.3% effective rate and 16.7% ineffective rate in CCNL. There was no significant difference statistically in effective rates between two period of time in nucleoplasty group (0.5>P>0.25). There was a significant difference statistically in effective rates between two period of time in CCNL group (P<0.05) . After three months, there was no significant difference statistically in effective rates between nucleoplasty and CCNL(P>0.10). Conclusion:① Both of the two methods were really utility and have the advantages of less trauma, less bleeding, good spine stability after operation .②Nucleoplasty could reduce intervertebral disc internal pressure rapidly than CCNL, and was less influenced by other agents.