Objective To investigate the clinical efficacy in the treatment of lumbar intcrvcrtbral disc prolapse (LIDP)with double intcrvcntional therapy(pcrcuatancous lumbar disccctomy with forceps combined with cpidural chcmonuclcolysis). Methods 116 patients with LIDP proved by clinical and imaging data were treated by the double intcrvcntonal therapy,of which,68 cases were male, 4 8 were female cases. 84 cases were in acute stage,32 cases were in chronic stage. The excellent and good rate of double intcrvcntional therapy with single percutaneous lumbar disccctomy( PLD) (85 cases) were compared; the efficacy of acute stage and chronic stage of LlDP,thc different severity of L1DP were also compared. Results After consecutive follow-up for six months, the excellent and good rate of double intcrvcntional therapy by using Macnab critria was 72. 4 1 % (84/11 6) , which was significantly higher than that of PLD(37. 65% ,32/85) only (P = 0. 001<0. 05) ; the excellent and good rate of the patients in acute stage (78. 57% ,66/84 ) was significantly higher than that of chronic stage (56.25%,18/32);thc excellent and good rate of slightly severe ( I degree) LIDP group (75%,51/68) was significantly higher than that of more severe ( Ⅱ and Ⅲ dcgrcc)LIDP group (54. 17%,26/48). Conclusion The double intcrvcntional therapy is an effctive method in treating LIDP,it can improve the excellent and good rate in the intcrvcntional treatment of LIDP.%目的 探讨钳取式经皮腰椎间盘切除术联合盘外胶原酶化学溶核术的双介入疗法对腰椎间盘脱垂的治疗效果.方法 用双介入方法治疗经临床及影像资料确诊的腰椎间盘脱垂患者共116例,其中男68例,女48例.急性发作期患者84例,慢性期患者32例.用双介入治疗方法治疗的患者与早期及同期用相同纳入与排除标准进行钳取式经皮腰椎间盘切除术治疗患者的疗效进行比较;对急性发作期治疗的患者与慢性期患者的疗效进行比较;对不同脱垂程度的椎间盘脱垂患者的疗效进行比较.结果 对患者分别进行6个月的随访,用Macnab标准进行疗效评价,双介入方法治疗的优良率为72.41%,高于单用经皮腰椎间盘切除术37.65%的优良率(P=0.001<0.05); 急性期患者治疗的优良率为78.57%,高于慢性期患者56.25%的优良率(P=0.016<0.05);轻度脱垂治疗的优良率为75%,高于重度脱垂患者54.17%的优良率(P=0.019<0.05).结论 双介入方法结合了2种介入治疗方法的特点,可提高椎间盘脱垂介入治疗的有效率.
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