胸腔镜下胸椎侧凸前路松解术胸壁锁孔的选择  

Portal pattern selection in thoracoscopic anterior release for thoracic scoliosis

作　　者：朱锋[1] 邱勇[1] 王斌[1] 俞杨[1] 朱泽章[1] 钱邦平[1] 马薇薇[1] 

机构地区：[1]南京大学医学院附属鼓楼医院脊柱外科,南京210008

出　　处：《中国微创外科杂志》2006年第12期906-908,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨胸腔镜下胸椎侧凸前路松解术胸壁锁孔的选择。方法根据侧凸累及范围、预计松解节段数、患者体型将38例胸腔镜下胸椎侧凸前路松解术分为2组,单排锁孔组26例,双排锁孔组12例,比较2组锁孔数目、手术时间、术中出血量、术后引流量和临床疗效。结果与双排锁孔组比较,单排锁孔组锁孔数目少[(3.9±0.8)vs(4.5±0.9);t=-2.067,P=0.046],手术时间长[(183±50)minvs(142±42)min;t=2.463,P=0.019],2组术中出血量、术后引流量、松解节段、侧凸矫正率和术后矫正丢失率差异均无显著性(P>0.05)。无死亡、假关节及内固定并发症。结论单排锁孔适合畸形累及节段长,胸腔前后径短的患者;双排锁孔适合胸廓前后径大,侧凸累及短的患者,椎间盘切除较彻底,锁孔数目相对较多。Objective To investigate the selection and positioning of endoscopic portal for performing thoracoscopic anterior release for scoliosis. Methods A total of 38 cases of thoracic scoliosis was divided into two groups, One-Row Group（ n = 26） and Double-Row Group（n = 12） , according to the portal pattern which was determined by the number of released levels and patient＇ s stature. The number of portals, operation time, estimated blood loss, post-operative drainage, and clinical efficacy were compared between the two groups. Results As compared with the Double-Row Group, the One-Row Group had less number of portals （3.9 ± 0.8 vs4.5±0.9;t= -2.067,P=0.046） and longer operation time （183 ±50 min vs 142 ±42 min;t =2.463,P=0.019）. No significant differences were found between the two groups with regard to the blood loss, post-operative drainage, number of released levels, correction rate, and loss of correction （ P 〉 0.05 ）. No death, pseudoarthrosis, or implantation failure occurred. Conduslons One-row portal pattern is suitable for patients with long-segment deformity and short anteroposterior thoracic diameter, while double-row portal pattern is suitable for patients with short-segment deformity and long anteroposterior thoracic diameter.

关 键 词：胸腔镜 脊柱侧凸 松解术 锁孔 

分 类 号：R687.3[医药卫生—骨科学]