大剂量胶原酶联合臭氧盘内注射治疗巨大型腰椎间盘突出症48例疗效分析

摘要

目的:探讨大剂量胶原酶联合臭氧盘内注射治疗巨大型腰椎间盘突出症的临床效果及安全性.方法:对48例巨大型腰椎间盘突出症患者进行椎间盘造影后,经穿刺针向盘内缓慢注入50 mg/L臭氧30~50 ml,留针观察10 min,然后再根据突出物大小,注入溶于6~8 ml生理盐水的胶原酶1 800~2 400 u.结果:48例患者均成功地进行了椎间盘造影检查及介入治疗.术后随访6～12个月,显效36例,有效8例,无效4例,总有效率为91.7%;无严重并发症发生.结论:经皮穿刺大剂量胶原酶联合臭氧盘内注射治疗巨大型腰椎间盘突出症是一种安全、有效的治疗方法.%Objective: To investigate the therapeutic effect and safety of high-dose collagenase and ozone combined intradiscal injection for treatment of huge lumbar disc herniation. Methods: At first, 48 patients with huge lumbar disc herniation was carried out lumbar discography. Second, the medical ozone 30-50 ml were injected into intradiscal space, the ozone at 50 mg/L. Third, if no abnormal happened for 10 minutes, 1 800 u collagenase solved by 6 ml sodium chloride or 2 400 u collagenase solved by 8 ml sodium chloride was slowly injected into the lumbar disc. Results:The successful rate of discography and interventional therapy was 100%. Observation after 6 - 12 months of therapy showed that the cure rate and effective rate were 75. 0% (36/48) and 16. 7% (8/48) , respectively. The overall excellent rate was 91. 7%. The results of therapy were satisfied. No serious complications occurred in this group. Conclusions: Percutneous intradiscal combined injection of high-dose collagenase and ozone for treatment of huge lumbar disc herniation is an effective and safe method.