谭海涛,黄圣斌,谢兆林,江建中,秦 豪,李 颖,陈国平,甘锋平.导航导杆在椎间孔镜穿刺定位的应用[J].中国脊柱脊髓杂志,2017,(4):339-344.
导航导杆在椎间孔镜穿刺定位的应用
中文关键词:  导航导杆  椎间孔镜  穿刺定位  椎间盘突出
中文摘要:
  【摘要】 目的:探讨导航导杆引导椎间孔镜手术穿刺定位的作用,分析其可行性及临床应用价值。方法:选取2015年10月~2016年6月收治的腰椎间盘突出症患者60例,按入院顺序随机数字表法,分为导航组30例和传统组30例。两组均进行椎间孔镜手术,其中导航组采用导航导杆引导穿刺建立椎间孔镜工作套管,传统组采用传统C型臂X线机透视下建立椎间孔镜工作套管。比较两组术中穿刺次数、透视次数及穿刺时间及术后1d、3个月、6个月VAS评分。结果:两组患者术后腰腿痛症状即刻缓解,患肢直腿抬高试验转阴性。穿刺次数,导航组穿刺为1.10±0.31次,传统组为10.53±5.55次,差异具有统计学意义(P<0.05)。透视次数,导航组为8.30±1.24次,传统组为60.00±15.15次,差异具有统计学意义(P<0.05)。穿刺时间,导航组为5.05±2.01min,传统组为34.80±6.32min,差异具有统计学意义(P<0.05)。术后1d、3个月、6个月时VAS评分,导航组分别为2.6±0.8、1.8±0.4、1.4±0.3,传统组分别为2.8±1.1、2.1±0.2、1.6±0.5,两组病例VAS评分较术前降低(P<0.05),两组病例同时间点VAS评分比较,差异无统计学意义(P>0.05)。结论:利用导航导杆引可以精准引导椎间孔镜手术工作套管的建立,解决椎间孔镜技术的瓶颈问题,提高穿刺成功率,减少反复穿剌次数,避免副损伤及缩短穿刺时间,减少术者及患者X线辐射量,值得临床推广应用。
Application of navigation rod for puncture and positioning in percutaneous endoscopic lumbar discectomy
英文关键词:Navigation rod  Percutaneous endoscopic lumbar discectomy  Puncture and locate  Lumbar disc herniation
英文摘要:
  【Abstract】 Objectives: To discuss the effect of navigation rod in percutaneous endoscopic lumbar discectomy(PELD), and to analyze its feasibility and value. Methods: 60 consecutive patients with lumber disc herniation were divided into navigation group and tradition group, each group had 30 cases. Two groups received percutaneous endoscopic lumbar discectomy. Those who received self-made navigation rod to puncture were considered as navigation group, and those who received the traditional C-arm fluoroscopy for puncturing were considered as tradition group. The puncture times, fluoroscopic exposure times, puncture time and VAS after operation between 2 groups were compared. Results: All patients reached good pain relief, and Lasergue sign turn to negative. Compared with the two groups, the average of puncture times were 1.10±0.31 and 10.53±5.55 respectively in navigation group and tradition group(P<0.001). The fluoroscopic exposure times were 8.30±1.24 and 60±15.15 in navigation group and tradition group(P<0.001). The puncture time was 5.05±2.01min and 34.80±6.32min respectively in navigation group and tradition group(P<0.001). The postoperative(1 day, 3 months, 6 months) VAS score of navigation group was 2.6±0.8, 1.8±0.4, 1.4±0.3 respectively, while the VAS score of tradition group was 2.8±1.1, 2.1±0.2, 1.6±0.5 respectively, postoperative VAS scores of the two groups were lower than preoperative ones(P<0.05). There was no statistically difference between two groups with respect to the postoperative ones(P>0.05). Conclusions: It can solve the bottleneck problem of PELD, and improve the success rate of puncture, reduce puncture times, avoid injury and reduce puncture time, greatly reduce the X-ray exposure to surgeon and patient by using the navigation rod, which is worthy of clinical application.
投稿时间:2016-10-10  修订日期:2017-04-02
DOI:
基金项目:
作者单位
谭海涛 广西医科大学第八附属医院骨科 537100 广西贵港市 
黄圣斌 广西医科大学第八附属医院骨科 537100 广西贵港市 
谢兆林 广西医科大学第八附属医院骨科 537100 广西贵港市 
江建中  
秦 豪  
李 颖  
陈国平  
甘锋平  
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