胶原酶溶解术治疗颈椎间盘突出症2769例临床分析.doc

胶原酶溶解术治疗颈椎间盘突出症2769例临床分析 　摘 要 目的：回顾性总结胶原酶溶解术治疗颈椎间盘突出症的临床疗效及不良反应，探讨胶原酶溶解术治疗颈椎间盘突出症的临床实用价值。方法：收集2006年1月至2015年12月经颈椎MRI扫描证实为颈椎间盘突出症，接受胶原酶溶解术治疗，且资料完整的2 769例患者进行疗效分析。结果： 2 769例中，疗效优1 440例（52.0%）、良787例（28.4%）、可351例（12.7%）、差191例（6.9%）；优良率为80.4%，总有效率为93.1%。未发现明显不良反应。结论：胶原酶溶解术治疗颈椎间盘突出症安全、有效，其作用机制有待进一步研究。　　关键词 胶原酶溶解术 颈椎间盘突出症 疗效分析　　中图分类号：R681.53； R977.3 文献标识码：A 文章编号：1006-1533（2016）17-0014-02　　Clinical analysis of collagenase chemonucleolysis in the treatment of 2 769 cases of cervical disc herniation　　QIU Xiangzhong*， XIA Aimin， JIANG Shengchang， TANG Hao， ZHANG Xincheng， YI Zhengyu， LI Zhiqiang（Department of Orthopaedics and Traumatology， the Hospital affiliated to Traditional Chinese Medicine Institute　　of Hunan Province， Changsha 410006， China）　　ABSTRACT Objective： The clinical efficacy and adverse reactions of collagenase chemonucleolysis in the treatment of cervical disc herniation were retrospectively summarized and its clinical value was also discussed. Methods： Twenty-seven hundreds and sixty-nine cases of patients with cervical disc herniation undergoing collagenase chemonucleolysis with complete data were collected and the efficacy of treatment was analyzed. Results： There were 1 440 cases （52.0%） with excellent efficacy， 787 cases （28.4%） with good efficacy， 351 cases （12.7%） with medium efficacy and 191 cases （6.9%） with bad efficacy among 2 769 cases， in which the excellent rate and the total effective rate accounted for 80.4% and 93.1%. None of significant adverse reactions was found. Conclusion： Collagenase chemonucleolysis is safe and effective in the treatment of cervical disc herniation， however its mechanism of action remains to be further studied.　　KEY WORDS collagenase chemonucleolysis； cervical disc herniation； efficacy analysis　　为总结胶原酶溶解术治疗颈椎间盘突出症的临床疗效，对我科2006年1月至2015年12月对经颈椎MRI扫描证实为颈椎间盘突出症，接受胶原酶溶解术治疗，且资料完整的2 769例患者进行疗效分析，现报告如下。　　1 临床资料　　本组2 769例，男1 841例，女928例，年龄25～64岁，平均年龄42岁， 突出部位：颈3～4节突出543例，颈4～5节突出869例，颈5～6节突出791例，颈6～7节突出566例。所有病例均符合入选标准：①年龄le;60岁；②明