目的 观察和分析盘外与盘内外胶原酶注射治疗腰椎间盘突出症的临床效果及其与突出物缩小率的关系.方法 对分别行盘外注射(A组)与盘内外联合注射(B组)的腰椎间盘突出症患者各150例作回顾性分析.根据Macnab标准评定近、远期疗效；复查CT影像,测量手术前后椎间盘突出指数(IDH),计算出椎间盘突出物缩小率；对Macnab评定结果与突出物缩小率行相关性分析.结果 A组与B组的近期疗效差异无统计学意义,但B组的远期疗效优于A组(P＜0.05),B组的突出物缩小率明显高于A组(P＜0.05),远期疗效与突出物缩小率呈正相关.结论 盘外与盘内外胶原酶注射均为治疗腰椎间盘突出症的有效方法,盘内外注射的远期疗效及突出物缩小率较单纯盘外注射更显著.%Objective To observe the therapeutic effect of intradisc or intra-combined-extra disc collagenase injection on lumbar intervertebral disc herniation. Methods Three hundred patients suffering lumbar intervertebral disc herniation received intradisc (group A) or intra-combined-extra disc(group B) collagenase injection were retrospectivly analysed. According to Macnab criteria and protrusion reducing rates,cases was analysed at different period after operation. Results There were no statistically differences in short-term efficacy between group A and group B, while there was a statistically significant differences between long-term efficacy and protrusion reducing rates (P < 0. 05). The long-term efficacy are closely related with protrusion reducing rates. Conclusion Intradisc or intra-combined-extra disc collagenase injection are both effective methods in treating lumbar intervertebral disc herniation. The long-term efficacy and protrusion reducing rates of intra-combined-extra disc injection are greater than that of intradisc injection.
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