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·骨肌疾病·

CT引导介入治疗腰椎间盘突出症

作者:曾庭基 许国增

所属单位:广州市番禺区沙湾人民医院放射科 (广州 广东 511483)

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摘要

目的 探讨CT引导射频结合胶原酶介入治疗腰椎间盘突出症的临床应用价值。方法 对48例临床诊断为腰椎间盘突出 症、经CT检查证实的患者进行CT导引下射频联合胶原酶介入治疗,全部病例进行突出物内射频热凝和突出物内注射 0.45 ml 275 U 胶原酶,其中L4/5椎间盘病变 23例,L5/S1 椎间盘病变25例。结果 穿刺成功率100%,6个月后随 访,腰椎间盘突出症状缓解情况:优25例、良20例、可3例、差0例。CT复查突出物明显变小26例,部分变小22例。 本研究过程未出现过敏反应、神经根损伤等并发症。结论 CT引导介入治疗是腰椎间盘突出症的有效治疗方法。

Objective To investigate the clinical value of CT-guided percutaneous radiofrequency combined with collagenase treatment for lumbar disc hernia. Methods A total of 48 patients with lumbar disc hernia diagnosed by clinic and CT accepted CT-guided percutaneous radiofrequency combined with collagenase (0.45 ml 275 U) treatment. There were 23 cases of L4/5 lesions and 25 cases of L5/S1 lesions. Results Injection was done successfully in all patients. After 6 months, 48 patients were contacted for clinical follow-up and repeat CT examination were performed to verify the status of the herniated lumbar disc material. The clinical rate of excellence and good results were 93.7%. The protrusion reduced as by CT scan in 48 cases (100%). No allergic phenomena or neurologically adverse reactions were observed. Conclusion CT-guided percutaneous radiofrequency combined with collagenase is effective in treating lumbar disc hernia.

【关键词】胶原酶;射频;X线计算机;椎间盘;介入性

【中图分类号】R445; R681.5

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2015.03.024

前言

腰椎间盘突出是不同程度影响患者活动、生活及 工作的常见病,过去常需通过脊柱外科手术来解除神 经根、马尾受压症状,近年来微创技术已成为脊柱外 科发展方向,CT导引介入治疗单纯腰椎间盘突出症比 传统手术创伤小得多[1]。本研究对2009年11月至2013 年9月采用CT导引射频结合胶原酶介入治疗腰椎间盘 突出的48例病例报道如下。