简式穿刺内镜监视下置管法在经皮椎间孔镜腰椎间盘切除术穿刺中的应用  

Application of simple puncture endoscopic monitoring tube placement in PELD

作　　者：赵理平[1] 郑国权 宋锦程[1] 吴耀刚[1] 陈国兆 沙卫平[1] 王黎明[1] ZHAO Liping;ZHENG Guoquan;SONG Jincheng;WU Yaogang;CHEN Guozhao;SHA Weiping;WANG Liming(Spinal Surgery,the Affiliated Zhangjiagang Hospital of Soochow University,Suzhou 215600,China)

机构地区：[1]苏州大学附属张家港医院脊柱外科,江苏苏州215600 [2]中国人民解放军总医院第一医学中心脊柱外科,北京100000

出　　处：《实用医学杂志》2020年第22期3110-3115,共6页The Journal of Practical Medicine

基　　金：江苏省临床医学重点(编号:BE2019661);苏州市科技发展计划(民生科技)项目(编号:SYSD2018006);张家港市卫计青年科技项目(编号:ZJGQNKJ201701)。

摘　　要：目的探讨简式穿刺内镜监视下置管在经皮椎间孔镜腰椎间盘切除术(PELD)中的临床应用价值。方法统计分析经PELD治疗的单节段腰椎间盘突出症患者200例,分为常规靶向穿刺置管组(常规组)和简式穿刺内镜监视下置管组(简式组),比较两组的穿刺置管时间、透视次数、总手术时间和镜下操作时间等指标,采用视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)比较两组的术后临床效果。结果两组均无术后并发症。简式组穿刺置管时间、透视次数、手术时间均明显优于常规组(P<0.05)。两组内术后VAS评分和ODI较术前均明显降低(P<0.05);两组间VAS评分和ODI比较差异无统计学意义(P>0.05)。结论简式穿刺内镜监视下置管可明显缩短穿刺置管时间、减少透视次数,同时明显缩短手术时间,操作方法简便安全、疗效可靠,在临床中值得推广应用。Objective To explore the clinical application value of simple puncture endoscopic monitoring tube placement method in PELD.Methods A statistical analysis was performed on 200 patients with single segment lumbar disc herniation treated by PELD.The patients were divided into two groups(routine puncture group and simple puncture endoscopic monitoring tube placement group).The indexes of puncture time,frequency of fluoroscopy,total length of surgical duration and length of endoscopic duration were compared between the two groups.Visual analog score(VAS)and Oswestry disability index(ODI)were used to evaluate the clinical effect after operation.Results No surgical complications occurred in both groups.The puncture time and length of surgi⁃cal duration were shorter,and frequency of fluoroscopy was less in the simple group than in the routine group(P<0.05).The VAS score and ODI in both groups were significantly lower than those before operation(P<0.05).There were no significant differences in VAS score and ODI between the two groups.Conclusions Simple puncture endoscopic monitoring tube placement can shorten the puncture time and length of surgical duration,reduce fre⁃quency of fluoroscopy.It is safe and effective,which is worth popularizing and applying in PELD.

关 键 词：简式穿刺 内镜监视下置管 椎间孔镜手术 腰椎间盘突出症 椎间盘切除术 

分 类 号：R681.57[医药卫生—骨科学]