椎间孔镜手术两种软组织扩张方法比较  

Comparison of two methods of soft tissue expansion in transforaminal endoscopic surgery

作　　者：吴洁石 薛骏 徐瑞生 WU Jieshi;XUE Jun;XU Ruisheng(Department of Orthopedics,Affiliated Hospital of Jiangnan University(Wuxi Third Hospital),Wuxi,Jiangsu 214041,China)

机构地区：[1]江南大学附属医院(无锡三院)骨科,江苏无锡214041

出　　处：《中国骨科临床与基础研究杂志》2020年第2期74-78,共5页Chinese Orthopaedic Journal of Clinical and Basic Research

基　　金：无锡市卫生健康委科研重大项目(Z201912)。

摘　　要：目的比较椎间孔镜手术中两种软组织扩张方法的效果差异。方法将2018年1月至2019年12月63例椎间孔镜手术患者随机分为标准组和切开器组。标准组30例,采用标准法进行软组织扩张;切开器组33例,运用深筋膜切开器放射状切开深筋膜后再行软组织扩张。记录局麻药使用量和软组织扩张操作时间,采用视觉模拟量表(VAS)评估软组织扩张疼痛状况。结果与标准组比较,切开器组局麻药使用量、软组织扩张操作时间和扩张软组织疼痛VAS评分均有所降低,两组比较,差异有统计学意义(P<0.05)。结论在椎间孔镜手术中,运用深筋膜切开器进行软组织扩张在减少局麻药使用量、缩短操作时间及减轻软组织扩张疼痛感等方面具有一定优势。Objective To compare the differences of effects between two methods of soft tissue expansion in transforaminal endoscopic surgery.Methods A total of 63 patients undergoing transforaminal endoscopic surgery from January 2018 to December 2019 were randomly divided into the standard group(n=30)and the cutter group(n=33).In the standard group,patients underwent soft tissue expansion using the standard method,while in the cutter group,deep fascia was cut radially with deep fascia cutter,then the soft tissue dilation was performed.Local anesthetic dosage and operation time of soft tissue dilation were recorded,visual analogue scale(VAS)was used to evaluate soft tissue dilation pain.Results Compared with the standard group,the dosage of local anesthetics,operation time of soft tissue expansion and VAS score of soft tissue dilation pain in the cutter group were all lower,the differences between two groups were statistically significant(P<0.05).Conclusion Deep fascia cutter for soft tissue dilatation during transforaminal endoscopic surgery has some advantages in reducing local anesthetics dosage,shortening operation time and alleviating soft tissue dilatation pain.

关 键 词：腰椎 椎间盘移位 椎管狭窄 椎间孔镜 组织扩张 筋膜切开术 

分 类 号：R443.7[医药卫生—诊断学] R681.57[医药卫生—临床医学]