【摘要】：第一部分椎體強化術骨水泥灌注壓力測定裝置的研制目的:設計并研制一套能夠直接測定椎體強化術時骨水泥灌注壓力的裝置,為臨床手術提供直觀的壓力數(shù)據(jù)參考,以減少骨水泥滲漏,降低手術風險。方法:根據(jù)椎體強化術的相關特點和椎體的解剖學結構,在已有的手術器械基礎上,運用相關物理學原理,設計能夠直接測定骨水泥灌注壓力的裝置。結果:設計并研制了能夠直接測定椎體強化術時骨水泥灌注壓力的測定裝置。包括應變片、推桿、電橋電路、信號放大調理器和數(shù)據(jù)采集示波器。結論:此套裝置可用于監(jiān)控和測定椎體強化術中骨水泥的灌注壓力,降低骨水泥滲漏,降低手術風險,減少并發(fā)癥的發(fā)生。第二部分椎體后凸成形術中骨水泥灌注壓力的測量目的:利用自主研制的椎體強化術骨水泥灌注壓力測定裝置研究室溫20℃下和模擬體內(nèi)溫度37℃下椎體后凸成形術中骨水泥灌注壓力在椎體內(nèi)的變化。方法:取脊柱胸腰椎標本(T10-L4),共10個椎體,將椎體隨機分為2組:第一組(室溫20℃)、第二組(模擬體內(nèi)溫度37℃),分別對第一組和第二組利用上海凱利泰公司的椎體后凸成形術手術器械進行單側椎體后凸成形術,采用自主研制的骨水泥灌注壓力測定裝置記錄骨水泥的動態(tài)灌注壓力。結果:椎體后凸成形術中骨水泥灌注壓力隨骨水泥灌注量的增加而升高。20℃組第一管骨水泥平均灌注壓力為6.34±2.05N,最大灌注壓力為10.74±3.32N;第二管骨水泥平均灌注壓力為9.42±1.69N,最大灌注壓力為18.18±1.77N。37℃組第一管骨水泥平均灌注壓力為9.68±1.36N,最大灌注壓力為17.95±1.72N;第二管骨水泥平均灌注壓力為15.66±2.10N,最大灌注壓力為23.06±2.10N。結論:1.椎體后凸成形術中骨水泥灌注壓力受到溫度及骨水泥灌注量影響。2.臨床上行椎體后凸成形術時應考慮體內(nèi)外溫度梯度對骨水泥灌注壓力的影響,應盡量縮短骨水泥灌注時間。3.椎體后凸成形術時實時監(jiān)控骨水泥灌注壓力可有效預防骨水泥滲漏,提高手術安全性。
[Abstract]:Objective: to design and develop a set of apparatus which can directly measure the pressure of bone cement perfusion during vertebral body augmentation, and to provide an intuitionistic data reference for clinical operation. To reduce bone cement leakage, reduce the risk of surgery. Methods: according to the related characteristics and anatomical structure of the vertebral body, based on the existing surgical instruments and relevant physics principles, a device was designed to directly measure the pressure of bone cement perfusion. Results: an apparatus was designed and developed to directly measure the pressure of bone cement perfusion during vertebra augmentation. Including strain gauge, push rod, bridge circuit, signal amplifier regulator and data acquisition oscilloscope. Conclusion: this device can be used to monitor and measure the pressure of bone cement perfusion, reduce the leakage of bone cement, reduce the risk of operation and reduce the incidence of complications. The second part of the measurement of bone cement perfusion pressure in kyphoplasty objective: to study the protruding of vertebral body at 20 鈩，

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