经腹穿刺L_5/S_1椎间盘切吸术  

Transabdominal L_s,S_1,, Lumbar Diskectomy

作　　者：生琦瑞[1] 郑延波[1] 王云强[1] 王洪波[1] 房台生[1] 

机构地区：[1]烟台市毓璜顶医院,264000

出　　处：《医学影像学杂志》1998年第3期146-149,共4页Journal of Medical Imaging

摘　　要：目的：探索对L5／S1椎间盘严重中央型、中央旁型突出或／和突出并迁移的有效治疗新途径，扩展介入治疗的适应症范围。材料与方法：通过对人体解剖动物实验和影像对照研究，自制和改良介入器械，采用消化道造影和下腹穿刺点加压法，经腹穿刺L5／S1椎间盘前部纤维环，建立通道行椎间盘切吸术。结果：本组32例，经腹椎间盘切吸均获成功，1例术中发生小肠损伤（穿孔），近中期显效率81．2％。结论：本疗法患者体位舒适，可避免腰肌和神经根损伤，术中钳端可行多角度钳取而且可穿过纤维环钳取椎管和椎间孔内之迁移椎间盘组织，具有损伤少，痛苦少，恢复快等优点，为发病率高的L5／S1椎间盘突出症提供了一种新的介入治疗途径。Purpose:It intends to explore an effective treatment for severe central type of L5/S1 intervertebral disc,protrusion of lateral central type or protrusion with shifting. Scope of indications for intervened treatment extended. Materials and methods: Through anatomy of human body and animal experiment, image contrast and research,so as to self-manufacture and improve intervening epuipment,introductron of image of digestive organ and pressure on the lower abdominal puncture,translaparopuncture L5/S1 anterior fibrous ring of intervertebral disc to create a passage for the intervertebral disc dissecting and aspirating technique. Results: 32cases of this group have turned out to be successful. One case ended with injury of the small intestine (puncture),average efficiency 81. 2 %.Conclusion: This treatment provides comfort f0r patient's posture,avoiding damage to the lumbar muscle and nerve root. The end of the forceps can be managed in various angles during surgery and through the fibrous ring vertebral tube can be taken,resulting in less damage to the shifting of vertebral pores and disc tissue,with less pain and quick recovery,providing a new approach to the intervening treatment of intervertebra1 disc protrusion.

关 键 词：椎间盘切吸术 经腹穿刺 L5/S1椎间盘 椎间盘突出症 介入治疗 消化道造影 神经根损伤 椎间盘组织 有效治疗 介入器械 对照研究 动物实验 人体解剖 小肠损伤 患者体位 椎间孔内 纤维环 中央型 适应症 加压法 穿刺点 显效率 

分 类 号：R681.530.5[医药卫生—骨科学] R681.53[医药卫生—外科学]