介入放射学杂志
介入放射學雜誌
개입방사학잡지
JOURNAL OF INTERVENTIONAL RADIOLOGY
2010年
3期
201-204
,共4页
张洪新%王执民%马锌明%陈士新%彭建明%张武平%钱学江%王玉贤%冉宪章%李波%窦建明%贺朝
張洪新%王執民%馬鋅明%陳士新%彭建明%張武平%錢學江%王玉賢%冉憲章%李波%竇建明%賀朝
장홍신%왕집민%마자명%진사신%팽건명%장무평%전학강%왕옥현%염헌장%리파%두건명%하조
臭氧%椎间盘突出症%髓核溶解
臭氧%椎間盤突齣癥%髓覈溶解
취양%추간반돌출증%수핵용해
ozone%disc protrusion%epidural injection of collagenase
目的 探讨经皮穿刺臭氧盘内注射联合胶原酶盘外溶解术,治疗腰椎间盘突出症的疗效及安全性.方法 按统一的选择标准[纤维环破裂、髓核突出幅度在10 mm以内、压迫硬膜囊或(和)神经根的腰椎间盘突出症]、治疗方法(臭氧盘内注射联合胶原酶盘外溶解),对行臭氧盘内注射术加联合胶原酶盘外溶解术、资料完整的腰椎间盘突出症541例患者进行复诊、书信、电话等方式随访观察,随访时间和例数分别为:2～3个月(近期)541例,4～12个月(中期)312例,13～18个月(远期)115例,按统一的疗效标准评价臭氧盘内注射联合胶原酶盘外溶解术的近、中、远期疗效,并与有关多中心单纯行胶原酶盘外溶解术例疗效进行对比.结果 所选病例近、中、远期有效率分别为95.9%(519/541)、90.4%(489/541)、87.2%(472/541);两种方法联合应用,突出的髓核有明显的不同程度的网缩,平均缩小30.5%;单纯行胶原酶溶解术近、中、远期有效率分别为89.5%、82.4%、80.4%.结论 臭氧盘内注射联合胶原酶盘外溶解术是纤维环破裂、髓核突出幅度在10 mm以内、压迫硬膜囊或(和)神经根的腰椎间盘突出症的一种高效的治疗方法,其疗效优于单纯胶原酶溶解术,臭氧对髓核的挛缩作用具有重大临床意义.
目的 探討經皮穿刺臭氧盤內註射聯閤膠原酶盤外溶解術,治療腰椎間盤突齣癥的療效及安全性.方法 按統一的選擇標準[纖維環破裂、髓覈突齣幅度在10 mm以內、壓迫硬膜囊或(和)神經根的腰椎間盤突齣癥]、治療方法(臭氧盤內註射聯閤膠原酶盤外溶解),對行臭氧盤內註射術加聯閤膠原酶盤外溶解術、資料完整的腰椎間盤突齣癥541例患者進行複診、書信、電話等方式隨訪觀察,隨訪時間和例數分彆為:2～3箇月(近期)541例,4～12箇月(中期)312例,13～18箇月(遠期)115例,按統一的療效標準評價臭氧盤內註射聯閤膠原酶盤外溶解術的近、中、遠期療效,併與有關多中心單純行膠原酶盤外溶解術例療效進行對比.結果 所選病例近、中、遠期有效率分彆為95.9%(519/541)、90.4%(489/541)、87.2%(472/541);兩種方法聯閤應用,突齣的髓覈有明顯的不同程度的網縮,平均縮小30.5%;單純行膠原酶溶解術近、中、遠期有效率分彆為89.5%、82.4%、80.4%.結論 臭氧盤內註射聯閤膠原酶盤外溶解術是纖維環破裂、髓覈突齣幅度在10 mm以內、壓迫硬膜囊或(和)神經根的腰椎間盤突齣癥的一種高效的治療方法,其療效優于單純膠原酶溶解術,臭氧對髓覈的攣縮作用具有重大臨床意義.
목적 탐토경피천자취양반내주사연합효원매반외용해술,치료요추간반돌출증적료효급안전성.방법 안통일적선택표준[섬유배파렬、수핵돌출폭도재10 mm이내、압박경막낭혹(화)신경근적요추간반돌출증]、치료방법(취양반내주사연합효원매반외용해),대행취양반내주사술가연합효원매반외용해술、자료완정적요추간반돌출증541례환자진행복진、서신、전화등방식수방관찰,수방시간화례수분별위:2～3개월(근기)541례,4～12개월(중기)312례,13～18개월(원기)115례,안통일적료효표준평개취양반내주사연합효원매반외용해술적근、중、원기료효,병여유관다중심단순행효원매반외용해술례료효진행대비.결과 소선병례근、중、원기유효솔분별위95.9%(519/541)、90.4%(489/541)、87.2%(472/541);량충방법연합응용,돌출적수핵유명현적불동정도적망축,평균축소30.5%;단순행효원매용해술근、중、원기유효솔분별위89.5%、82.4%、80.4%.결론 취양반내주사연합효원매반외용해술시섬유배파렬、수핵돌출폭도재10 mm이내、압박경막낭혹(화)신경근적요추간반돌출증적일충고효적치료방법,기료효우우단순효원매용해술,취양대수핵적련축작용구유중대림상의의.
Objective To investigate the curative effect and safety of percutaneous intradiscal injection of ozone combined with epidural injection of collagenase for the treatment of prominent lumbar disc protrusion.Methods A total of 541 patients with lumbar disc protrusion were included in this study.All the patients fulfilled the following criteria:the fibrous ring was broken,the protruded extent of nucleus pulposus was less than 10 mm and the dura sac and/or nerve root was compressed.The intradiscal injection of ozone combined with epidural injection of collagenase was performed in all patients.The patients were followed up through further consultation,letters,telephone or other ways.Five hundred and forty-one cases were followed up for 2-3 months(short-term),312 cases for 4-12 months(medium-term)and 115 cases for 13-18 months(ling-term).The short-term,medium-term and long-term curative effects were evaluated with unified curative criteria,and the results were compared with that obtained with the treatment of epidural injection of collagenase only. Results The short-term, medium-term and long-term effective rate of selected cases was 95.9%(519/541),90.4%(489/541)and 87.2%(472/541),respectively.When combined application of two methods was performed,different degree of shrinkage of the protruded nucleus pulposus was obviously observed,with a mean shrinkage degree of 30.5%.The short-term,medium-term and long-term effective rate of simple collagenase chemonucleolysis was 89.5%,82.4%and 80.4%,respectively.Conclusion Intradiscal injection of ozone combined with epidural injection of collagenase is an effective treatment for lumbar disc protrusion when the fibrous ring is broken,the protruded extent of nucleus pulposus is less than 10 mm and the dura sac and/or nerve root is compressed. Its curative effect is superior to simple collagenase chemonucleolysis. Ozone is of clinical significance for producing the shrinkage of the nucleus pulposus.
