摘要
目的:观察臭氧溶核术治疗椎间盘源性下腰痛的远期疗效,并对照研究经典椎间盘造影术和臭氧椎间盘造影术诊断椎间盘源性下腰痛的价值。方法:对207例需进行臭氧溶核术的椎间盘源性下腰痛患者行前瞻性研究,在术中对疑似病变椎间盘先后进行经典椎间盘造影和臭氧椎间盘造影,分别观察诱发疼痛反应及病理分型。随访术后1年、2年、3年患者的视觉模拟疼痛评分(VAS)。对术前和术后的VAS进行加权处理并评价疗效,同时对两种椎间盘造影术诱发疼痛试验阳性率进行对照,用SPSS 10.0统计软件进行统计学处理。结果:实际随访到病例181例,占入组随访病例的87.4%。术后随访1年、2年、3年的总有效率分别为88%、72%、78%,优良率为67%、63%、57%。在治疗有效者的243个间盘和治疗无效的62个间盘中臭氧诱发痛发生率分别为89.7%和45.2%,比较有明显差异。臭氧椎间盘造影诱发疼痛试验阳性率比经典椎间盘造影明显升高(57%:25%)。结论:臭氧溶核术治疗椎间盘源性下腰痛的远期疗效稳定,术中臭氧诱发痛与疗效呈正相关,且诱发疼痛试验阳性率明显高于经典椎间盘造影术。
Objective： To investigate the long-term effect of curing discogenic low back pain with chemonucleoysis collagenase. Methods： By means of making the visual simulation pain score（VAS） for 207 patients who need operation before the chemonueleoysis with collagenase, doing diskography, sorting the types of intervertebral discs, and investigating whether evoked -pain happens or not by contrast medium and ozone during the process. Follow up and record the VAS of patients by telephone after the treatment on yearly basis for three years, to compare the effects. Meanwhile, calculate the evoked pain of contrast medium and ozone, and process the data with SPSS 10.0. Results： Acturally 181cases were followed up, which takes up 87.4% of the total. The percentage of efficiency are 88% ,72% ,78% individually based on the three years after the treeatment. The percentage of excellence rate are 67% ,63% ,57%. The percentages of evoked pain are 89.7% （P 〈 0.05 ） and 45.2% by ozone in the effect and ineffectiveness. The rate of evoked pain by contrast medium and ozone have different, the later is obvious rise. Conclusions： the long-term effect for chemonucleoysis with collagenase is stabilized, and is positively related with the evoked pain by ozone in the operation.
出处
《中国疼痛医学杂志》
CAS
CSCD
2011年第5期262-265,共4页
Chinese Journal of Pain Medicine
