破裂型腰椎间盘突出症手术失误原因分析及预防  

Analysis and prevention of the Causal Factors of Failed Initial Operation for Ruptured Lumbar Disc Herniation

作　　者：张军喜[1] 迟玉春[1] 刘玉祥[1] 葛文学[1] 王世界[1] 

机构地区：[1]日照市人民医院,山东日照276800

出　　处：《实用骨科杂志》2002年第1期1-3,共3页Journal of Practical Orthopaedics

摘　　要：目的 :通过分析破裂型腰椎间盘突出症初次手术失误原因 ,提出预防措施。方法 :我院 1985年至 2 0 0 0年共手术治疗破裂型腰椎间盘突出症 113例 ,对 2 1例 (其中 7例由外院转入 )因初次手术失误而再手术病人进行回顾性分析。结果 :初次手术失误原因主要为 :(1)髓核遗漏、遗留过多或复发。 (2 )合并其它节段间盘突出未处理或复发。 (3)合并椎管或侧隐窝狭窄未处理。 (4 )合并马尾神经综合症。 (5 )医源性损伤。结论 :破裂型腰椎间盘突出症初次手术失误原因多与术中操作有关。主要预防措施 :(1)术前详细检查、明确诊断。(2 )术中定位准确、操作细致。(3)术后严密观察、正确康复。Objective:To analyse the causeds of the failed initial operation for ruptured lumbar intervertebral disc herniation and put forward preventive measures.Methods:113 cases with ruptured lumbar intervertebaral disc herniation were treated with operation.21 cases (including 7 cases transfered form other hospitals) treated with reoperation because of failed initial operation were studied.Results:The main causes of the failed initial operation were:leaving the partial or more nuclear pulpuosos and recurrence of disc herniation,omited or recurred disc herniation in other spaces,undcompressing spinal or lateral recess stenosis,combining cauda equina syndrome and iatrogenic injury.Conclusions:The causes of the failed initial operation for ruptured lumbar intervertebral disc herniation were always related with intraoperative manipulation.The main preventive measures were:detailed preoerative examination,clear diagnosis,exact intraoperative location,careful manipulation,careful postoperative observation and correct rehabilitation.

关 键 词：破裂型腰椎间盘突出症 手术失误 预防措施 医源性损伤 

分 类 号：R681.53[医药卫生—骨科学]