發(fā)布時間：2018-03-17 01:31

  本文選題：腰椎間盤突出癥　切入點：經(jīng)皮椎間孔鏡椎間盤切除術　出處：《中國矯形外科雜志》2017年23期 　論文類型：期刊論文

【摘要】：[目的]探討輔助椎間孔周圍浸潤麻醉對經(jīng)皮腰椎間孔鏡髓核摘除術中鎮(zhèn)痛的療效。[方法]將64例單節(jié)段腰椎間孔鏡下髓核摘除術治療的患者隨機分為椎間孔浸潤組和逐層浸潤組。椎間孔浸潤組于棘突旁開約4 cm予0.5%利多卡因行關節(jié)突外側(cè)及椎間孔浸潤麻醉;逐層浸潤組采用逐層利多卡因浸潤麻醉。記錄兩組手術時間、透視次數(shù),采用視覺模擬評分法(visual analogue scale,VAS)評估椎間孔成形及后縱韌帶處理時的疼痛,采用Likert五分量表法評價患者對局麻手術的體驗,并對再手術意愿進行調(diào)查。[結果]椎間孔浸潤組患者均順利完成手術,逐層浸潤組有3例術中在椎間孔成形時由于不能耐受疼痛而臨時增加靜脈強化鎮(zhèn)痛;兩組手術時間、透視次數(shù)差異不具有統(tǒng)計學意義(P0.05);椎間孔浸潤組椎間孔成形VAS評分為(4.74±1.05)分,逐層浸潤組(7.48±1.16)分,差異有統(tǒng)計學意義(P0.05)。后縱韌帶處理時椎間孔浸潤組VAS評分(3.74±0.62)分,逐層浸潤組(5.22±0.80)分,差異具有統(tǒng)計學意義(P0.05);椎間孔浸潤組的局麻體驗評價選擇好和很好的占75.00%,而逐層浸潤組僅31.25%;再手術意愿椎間孔浸潤組為87.00%,而逐層浸潤組為46.88%,差異具有統(tǒng)計學意義(P0.05)。[結論]輔助椎間孔周圍浸潤麻醉可以顯著減少椎間孔鏡術中的疼痛,且操作簡單,安全性高。
[Abstract]:[objective] to investigate the analgesic effect of assisted periforaminal infiltration anesthesia in percutaneous lumbar foramellar nucleus pulpotomy. [methods] Sixty-four patients undergoing single segmental intervertebral foramen endoscopy were randomly divided into intervertebral foramen dipping. The intervertebral foramen infiltration group was treated with 0.5% lidocaine to anaesthesia of lateral articular process and intervertebral foramen. Laminar infiltration group was anesthetized by layer by layer lidocaine. The operation time, fluoroscopy times and visual analogue score were used to evaluate the pain of intervertebral foramination and posterior longitudinal ligament treatment. The experience of local anaesthesia was evaluated by Likert quintile scale, and the willingness of reoperation was investigated. [results] all the patients in the intervertebral foramen infiltration group completed the operation successfully. In the laminar infiltrating group, 3 cases were temporarily increased intravenous analgesia during intervertebral foramination because of their intolerable pain. There was no significant difference in the operation time between the two groups (P 0.05), and the VAS score of intervertebral foramen formation in the intervertebral foramen infiltration group was 4.74 鹵1.05). The VAS score of the intervertebral foramen infiltration group was 3.74 鹵0.62 when the posterior longitudinal ligament was treated, and 5.22 鹵0.80 in the layer by layer infiltration group. The difference was statistically significant (P 0.05), the local anesthetic experience evaluation in the intervertebral foramen infiltration group was 75.00%, while that in the layer-by-layer infiltration group was only 31.25%, and that in the intervertebral foramen infiltration group was 87.00 and 46.88, respectively. The difference was statistically significant. [conclusion] Auxiliary periforaminal infiltration anesthesia can significantly reduce the pain in intervertebral foramen surgery. And the operation is simple, the security is high.
【作者單位】： 福建醫(yī)科大附屬第二醫(yī)院骨科;
【分類號】：R614

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本文編號：1622582