摘要
目的：对颈椎间盘内注射胶原酶的疗效进行评估；将治疗前后的椎间盘影像学变化同临床症状的改变相联系，以期阐明作用机制。方法：１９９７年６月～１９９８年６月使用国产胶原酶冻干制品，结合经皮切吸术治疗颈椎间盘突出症８例。胶原酶注射局部麻醉和影像增强监视下进行。１２００Ｕ的胶原酶溶于５ｍｌ无菌水中，取一半剂量注入每个突出的间盘，注射时间平均为１５ｍｉｎ。８例患者的１２个间盘在注射前后均作双盲法的影像学评价，患者在术后留院观察３天。结果：术后６～１２个月的随访观察表明，８例患者中７例（占８７％）的疼痛明显减轻或消失，无严重并发症发生，临床效果满意。１例有２个椎间盘突出的患者疼痛无减轻，疗效一般。突出物平均回缩１０％（与椎管前后径相比较），间盘信号均减低。５例患者的椎间盘突出持续存在。术后椎间盘突出存在与否和临床疗效无明显关联。结论：此研究结果表明，胶原酶溶核术是一种行之有效的治疗方法，其完善的治疗常规亟待建立。
Purpose:To establish a new method for treatment of herniation of cervical disc and to evaluate the effect of the method.The mechanism of action of this therapy was expounded by comparing the image changes of the cervical intervertabral disc with the changes of clinical symptom before and after operation.Methods:8 patients (6 men,2 women;age 34～60 years,average 49 years) with herniation of cervical disc were treated by percutaneous cervical discectomy (PCD) with chemonucleolysis from Jun.1997 to Jun.1998. Collagenase was injected under local anesthesia and surveillance of X ray image monitor. 1200U of collagenase was dissolved in 5ml sterile saline and half of which was injected into herniated disc.The injection time lasted for about 15 minutes. 8 patients with 12 herniated discs were evaluated before and after operation.Results:Observation after 6～12 months of therapy showed that the results of therapy were satisfied in 7 of the 8 patients (87%).The pain was relieved obviously or disappeared and no severe complication was found. The curative effect of 1 patient with 2 herniated discs was not obvious. The degree of retraction of herniated discs was 10% in average. The signals of the discs were all reduced.The herniations of cervical disc in 5 patients persisted. There were no obvious relation between persistence of herniation of discs and clinical response.Conclusion:Although our study included only a small number of sample, but the prelimanary result showed that the PCD combined with chemonucleolys is an effective method for treatment of herniation of cervical disc.
出处
《放射学实践》
1999年第2期67-70,共4页
Radiologic Practice
关键词
颈椎
椎间盘突出
髓核化学溶解术
Chemonucleolysis Collagenase Cervical disc herniation MRI
