自制辅助定位穿刺装置在经皮椎间孔镜下髓核摘除术中的应用效果  

Application effect of self-made assisted device for positioning puncture during percutaneous endoscopic lumbar discectomy

作　　者：曹正霖[1] 禤天航 于淼[1] 关宏刚[1] 王刚[1] 肖隆艺[1] 罗荣森 CAO Zheng-lin XUAN Tian-hang YU Miao GUAN Hong-gang WANG Gang XIAO Long-yi LUO Rong-sen(The First Department of Orthopaedics, Foshan Hospital of Traditional Chinese Medicine, Foshan 528000, Chin)

机构地区：[1]广东省佛山市中医院骨一科,佛山市528000

出　　处：《广西医学》2017年第9期1320-1324,共5页Guangxi Medical Journal

基　　金：广东省佛山市医学攻关项目(2015AB00359)

摘　　要：目的探讨自制辅助定位穿刺装置在经皮椎间孔镜下髓核摘除术(PELD)中的应用效果。方法选择单一节段椎间盘突出患者120例,其中病变位于L_(4/5)节段者60例,L_5/S_1者60例。将L_(4/5)节段患者随机分为A组与B组,各30例,将L5/S1节段患者随机分为C组与D组,各30例。4组均行PELD,其中A组与C组采用自制装置进行靶向穿刺置管,B组与D组采用常规经椎间孔入路技术进行穿刺置管。比较A、B两组和C、D两组的一次穿刺成功率、定位穿刺时间、置管时间以及手术透视次数。结果所有患者均顺利完成手术,术中及术后均未出现严重的并发症。A组与C组的一次穿刺成功率、定位穿刺时间、置管时间及术中X线透视次数分别优于B组与D组(P<0.05)。结论在PELD术中采用自制辅助装置能有效辅助行穿刺置管,有更高的穿刺效率,并降低术者和患者接受透视辐射次数。Objective To investigate the application effect of self-made assisted device for positioning puncture during percutaneous endoscopic lumbar discectomy （ PELD） .Methods A total of 120 patients with single segment disc herniation were selected .The lesions were located in L4/5（n=60） or L5/S1（n=60）.The patients with lesions located in L4/5 were randomly divided into group A and group B,with 30 cases in each group .The patients with lesions located in L 5/S1 were randomly divided into group C and group D , with 30 cases in each group.PELD was conducted in the four groups .Targeted puncture and catheterization using self-made assisted device were performed in group A and group C.Puncture and catheterization by conventional transforaminal approach were performed in group B and group D .The one-time successful rate of puncture,duration for location and puncture,duration for catheterization and the times of intraoperative X-ray were compared between group A and group B or between group C and group D.Results The operation was successfully completed in all patients.No severe complications occurred during or after operation .The one-time successful rate of puncture ,duration for location and puncture ,duration for catheterization,and the times of intraoperative X-ray of group A and group C were better than those of group B and group D respectively （P〈0.05）.Conclusion Application of self-made assisted device during PELD can provide an effective assistance for puncture and catheterization,with higher puncture effectiveness ,and can reduce the times of X-ray surgeons and patients received .

关 键 词：腰椎间盘突出症 经皮椎间孔镜 髓核摘除术 经椎间孔入路 辅助穿刺装置 

分 类 号：R681.5[医药卫生—骨科学]