髓核化学溶解术胶原酶治疗颈椎间盘突出附8-放射学实践杂志.PDF

放射学实践 1999, 14( 2) B67-70 67 ( ) ) ) ) 8 = : 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 的改 变相联系, 以期阐明作用机制: 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15min8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: 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: 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 = 髓核化学溶解术 胶原酶 颈椎间盘突出 磁共振成像 Chemonucleolysis with collagenase for treatment of herniation of cervical disc Hong Cheng, Zhou Yi heng, Wang Chengyuan, et al. Department of Radiology,Tongji Hospital of Tongji Medi al University, Wuhan 430030 = Abstract Purpose:To establish a new method for treatment of herniation of ervi al dis and to evaluate the effe t of the method.The me hanism of a tion of this therapy was expounded by omparing the image hanges of the ervi al intervertabral dis with the hanges of lini al symptom before and after operation. Methods : 8 patients ( 6 men, 2 women; age 34~ 60 years, average 49 years) with herniation of ervi al dis were treated by per utaneous ervi al dis e tomy ( PCD) with hemonu leolysis from Jun. 1997 to Jun. 1998. Collagenase was inje ted under lo al anesthesia and surveillan e of X-ray image monitor. 1200 U of ollagenase was dissolved in 5ml sterile saline and half of whi h was inje ted into herniated dis . The inje tion time lasted for about 15 minutes. 8 patients with 12 herniated dis s 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