简式穿刺内镜监视下置管技术在经皮椎间孔镜腰椎间盘切除术中的应用  

Clinical Application of Simple Puncture Endoscopic Monitoring Tube Placement in Percutaneous Endoscopic Lumbar Discectomy for Lumbar Disc Herniation

作　　者：赵理平[1] 郑国权 宋锦程[1] 吴耀刚[1] 沙卫平[1] 王黎明[1] Zhao Liping;Zheng Guoquan;Song Jincheng(Department of Spine Surgery,Affiliated Zhangjiagang Hospital of Soochow University,Suzhou 215600,China;不详)

机构地区：[1]苏州大学附属张家港医院脊柱外科,苏州215600 [2]中国人民解放军总医院第一医学中心脊柱外科,北京100853

出　　处：《中国微创外科杂志》2021年第1期52-55,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：苏州市科技发展计划(民生科技)项目(SYSD2018006);张家港市卫计系统青年科技项目(ZJGQNKJ201701)。

摘　　要：目的探讨经简式穿刺内镜监视下置管行经皮椎间孔镜腰椎间盘切除术(percutaneous endoscopic lumbar discectomy,PELD)治疗单节段腰椎间盘突出症的安全性和有效性。方法2018年1月~2019年8月行PELD治疗单节段腰椎间盘突出症122例,局麻下经简式穿刺内镜监视下置管完成手术。术后1、3、6个月及末次随访进行腰腿痛视觉模拟评分(Visual Analogue Score,VAS)、Oswestry功能障碍指数(Oswestry Disability Index,ODI)评定,采用改良MacNab标准评定疗效。结果手术均顺利完成,无并发症发生。穿刺置管时间(13.6±6.1)min,透视次数(6.2±5.1)次,手术时间(53.7±3.7)min。122例随访(17.3±6.1)月(10~25个月)。术后VAS评分和ODI均明显改善(均P=0.000)。末次随访改良MacNab标准优101例,良16例,可5例,优良率95.9%(117/122)。4例术后5~18个月复发,复发率3.3%。结论简式穿刺内镜监视下置管行PELD治疗单节段腰椎间盘突出症安全、有效,操作简单,无需特殊设备。Objective To explore the safety and effectiveness of simple puncture endoscopic monitoring tube placement method in the treatment of single segment lumbar disc herniation by percutaneous endoscopic lumbar discectomy(PELD).MethodsFrom January 2018 to August 2019,122 patients with single lumbar disc herniation were treated by PELD.The Visual Analogue Score(VAS)of pain and Oswestry Disability Index(ODI)were evaluated at 1 month,3 months and 6 months after operation.The modified MacNab criteria was used to evaluate the operative effect.Results All the operations were successfully completed without complications.The average puncture time was(13.6±6.1)min,the average fluoroscopy times was 6.2±5.1,and the average operation time was(53.7±3.7)min.The average follow-up period was(17.3±6.1)months(range,10-25 months)in the 122 cases.The VAS score and ODI were significantly improved after operation(all P=0.000).At the last follow-up,101 cases were excellent,16 cases were good and 5 cases were fair.The excellent and good rate was 95.9%(117/122).Four patients(3.3%)recurred 5-18 months after operation.Conclusions Simple puncture endoscopic monitoring tube placement is a safe and effective method in PELD for single lumbar disc herniation.It is easy to operate without special equipment.

关 键 词：腰椎间盘突出症 经皮椎间孔镜腰椎间盘切除术 内镜监视下置管 

分 类 号：R687.3[医药卫生—骨科学]