摘要
目的：观察康宁克通Ａ、利多卡因复合用于胶原酶盘外溶解术的作用。方法：随机将７０例患腰椎间盘突出症、经骶裂孔（硬膜外）前间隙置管注入胶原酶行盘外溶解术的患者分为三组。１、单纯胶原酶组（Ｃ组）；２、胶原酶、利多卡因组（Ｃ＋Ｌ组）；３、胶原酶、康宁克通Ａ、利多卡因组（Ｃ＋Ｋ＋Ｌ组）。结果表明：Ｃ＋Ｋ＋Ｌ组２周疼痛缓解率较Ｃ组、Ｃ＋Ｌ组明显增加。术后７天、１４天ＶＡＳ评分Ｃ＋Ｋ＋Ｌ组明显低于Ｃ组和Ｃ＋Ｌ组。２周直腿抬高试验好转率Ｃ＋Ｋ＋Ｌ组也明显高于Ｃ组。术后３个月近期疗效随访观察，Ｃ＋Ｋ＋Ｌ组优良率（９１％）虽高于Ｃ组（６７％），但３组间有效率无显著差异。本组总有效率达９７％，优良率达８１％。另外，本法将ＣＴ定位改进为用利多卡因试验剂量测定阻滞平面，以确定是否与病变椎间盘节段相符，然后注入治疗药，省却了ＣＴ定位的麻烦。从而使本法可以在基层医院推广应用，具重要临床价值。结论：１、经骶裂孔硬膜外前间隙胶原酶盘外溶解术是治疗腰椎间盘突出症的有效方法。２、康宁克通Ａ复合利多卡因用于胶原酶盘外溶解术可明显缓解术后２周内的疼痛，并可提高近期优良率。
Aim: To investigate the effect of extradisc injection of collagenase combined with kenacort A and lidocaine. 70 patients diagnosed lumbar disc herniation were randomly divided into three groups. 1. Group of collagenase(C group);2.Group of collagenase and lidocaine(C+L group); 3. Group of collagenase, kenacortA and lidocaine.(C+K+L group). Result: The rate of pain decrease in C+K+L group was significantly higer than C group and C+L group in 2 postoperative weeks. The rate of Straight Leg Rising in C+K+L group was significantly higher than C group in 2 postoperative weeks. In the postoperative 7th and 14th day, VAS of C+K+L group was significantly lower than C group and C+L group. It is concluded that the combined use of kenacortA and lidocaine can effectively prevent postoperative pain of extradisc injection of collagenase. The extradisc injection of collagenase via the anterior epidural spase is an effective method for the treatment of lumbar disc herniation. Three month of postoperative pain assessment revealed that 81% of total groups obtained excellent or good results, the total effective rate was 97%,the excellent or good rate of C+K+L group was significantly higher than C group.
出处
《中国疼痛医学杂志》
CAS
CSCD
1999年第2期70-73,共4页
Chinese Journal of Pain Medicine
关键词
康宁克通A
利多卡因
胶原酶溶解
腰椎间盘突出
KenacortA
Lidocaine
Anterior epidural space
Extradisc injection of collagenase.
