發(fā)布時間：2019-01-14 07:18

【摘要】：目的 :探討導(dǎo)航導(dǎo)桿引導(dǎo)椎間孔鏡手術(shù)穿刺定位的作用,分析其可行性及臨床應(yīng)用價值。方法 :選取2015年10月~2016年6月收治的腰椎間盤突出癥患者60例,按入院順序隨機數(shù)字表法,分為導(dǎo)航組30例和傳統(tǒng)組30例。兩組均進行椎間孔鏡手術(shù),其中導(dǎo)航組采用導(dǎo)航導(dǎo)桿引導(dǎo)穿刺建立椎間孔鏡工作套管,傳統(tǒng)組采用傳統(tǒng)C型臂X線機透視下建立椎間孔鏡工作套管。比較兩組術(shù)中穿刺次數(shù)、透視次數(shù)及穿刺時間及術(shù)后1d、3個月、6個月VAS評分。結(jié)果 :兩組患者術(shù)后腰腿痛癥狀即刻緩解,患肢直腿抬高試驗轉(zhuǎn)陰性。穿刺次數(shù),導(dǎo)航組穿刺為1.10±0.31次,傳統(tǒng)組為10.53±5.55次,差異具有統(tǒng)計學(xué)意義(P0.05)。透視次數(shù),導(dǎo)航組為8.30±1.24次,傳統(tǒng)組為60.00±15.15次,差異具有統(tǒng)計學(xué)意義(P0.05)。穿刺時間,導(dǎo)航組為5.05±2.01min,傳統(tǒng)組為34.80±6.32min,差異具有統(tǒng)計學(xué)意義(P0.05)。術(shù)后1d、3個月、6個月時VAS評分,導(dǎo)航組分別為2.6±0.8、1.8±0.4、1.4±0.3,傳統(tǒng)組分別為2.8±1.1、2.1±0.2、1.6±0.5,兩組病例VAS評分較術(shù)前降低(P0.05),兩組病例同時間點VAS評分比較,差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:利用導(dǎo)航導(dǎo)桿引可以精準(zhǔn)引導(dǎo)椎間孔鏡手術(shù)工作套管的建立,解決椎間孔鏡技術(shù)的瓶頸問題,提高穿刺成功率,減少反復(fù)穿剌次數(shù),避免副損傷及縮短穿刺時間,減少術(shù)者及患者X線輻射量,值得臨床推廣應(yīng)用。
[Abstract]:Objective: to explore the role of guiding guide rod in puncture localization of intervertebral foramen surgery, and to analyze its feasibility and clinical application value. Methods: from October 2015 to June 2016, 60 patients with lumbar disc herniation were randomly divided into navigation group (n = 30) and traditional group (n = 30). The two groups underwent intervertebral foramen surgery. The navigation group used the guide rod to guide the establishment of the intervertebral foramen working casing, and the traditional group used the traditional C-arm X-ray machine to establish the intervertebral foramen working casing. The times of puncture, the times of fluoroscopy, the time of puncture and the VAS score of 1 day, 3 months and 6 months after operation were compared between the two groups. Results: the symptoms of lumbago and leg pain in both groups were immediately relieved and the leg elevation test turned negative. The times of puncture were 1.10 鹵0.31 times in navigation group and 10.53 鹵5.55 times in traditional group (P0.05). The frequency of fluoroscopy was 8.30 鹵1.24 times in navigation group and 60.00 鹵15.15 times in traditional group (P0.05). The puncture time was 5.05 鹵2.01min in the navigation group and 34.80 鹵6.32min in the traditional group. The difference was statistically significant (P0.05). At 1 day, 3 months and 6 months after operation, the VAS score in navigation group was 2.6 鹵0.8 鹵0.4 鹵0.4 鹵0.3, and that in traditional group was 2.8 鹵1.1 鹵2.1 鹵0.21,1.6 鹵0.5, respectively. The VAS score in both groups was lower than that before operation (P0.05). There was no significant difference in VAS score between the two groups at the same time point (P0.05). Conclusion: the use of guide rod can accurately guide the establishment of intervertebral foramen operation casing, solve the bottleneck of intervertebral foramen technique, improve the success rate of puncture, reduce the times of repeated puncture, avoid collateral injury and shorten the puncture time. It is worth popularizing clinical application to reduce the X-ray radiation dose of the patients and the patients.
【作者單位】： 廣西醫(yī)科大學(xué)第八附屬醫(yī)院骨科;
【分類號】：R687.3
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本文編號：2408438