既往骨科手术经验在单侧双通道脊柱内镜技术学习中的作用  

Effect of previous orthopedic surgical experience on acquiring the unilateral biportal endoscopy technique

作　　者：边焱焱[1] 牛潼 余可谊[1] 王以朋[1] 仉建国[1] BIAN Yanyan;NIU Tong;YU Keyi;WANG Yipeng;ZHANG Jianguo(Department of Orthopaedics,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院骨科,北京100730

出　　处：《中华骨与关节外科杂志》2022年第2期122-128,共7页Chinese Journal of Bone and Joint Surgery

摘　　要：目的:通过问卷调查分析骨科医师对单侧双通道脊柱内镜(UBE)技术的认识,以及关节镜、经皮脊柱内镜椎间盘切除术(PELD)、开放手术经验在学习UBE技术时发挥的作用。方法:问卷调查时间为2021年6月1日至2021年6月30日。采用横断面调查的研究方法,利用微信平台定向发送问卷调查至专业研讨群、医师病例交流群及个人等。问卷调查对象为不同级别医院的骨科在职执业医师,通过扫描二维码匿名进入电子问卷界面(由问卷星平台提供技术支持)参与问卷调查。问卷调查主要内容包括被调查者的手术经验情况、对不同疾病首选治疗方式、不同手术技术难度评估及未来不同类型手术在脊柱外科总手术量占比的估计。结果:共收到有效问卷343份,被调查者中66.2%(227/343)既往有UBE手术经验,44.3%(152/343)有关节镜手术经验,94.5%(324/343)有脊柱开放手术经验,77%(264/343)有PELD手术经验。关节镜、PELD及开放手术对于学习UBE的作用主要在于提升操作手感、明确手术方位、辨认解剖结构及改变手术理念。77.8%(267/343)的被调查者首选PELD作为单纯椎间盘突出的手术方式,75.2%(258/343)的被调查者首选UBE作为椎管狭窄单纯减压的手术方式,而对于椎管狭窄且伴脊柱不稳需行内固定手术的病例,52.5%(180/343)的被调查者首选UBE作为手术方式。统计学结果表明,是否具有PELD或UBE手术经验,对于术者的术式选择具有重要影响。结论:关节镜、PELD及开放手术经验对于学习UBE技术具有重要作用,医师的既往手术经验情况会对治疗方案的选择产生影响。Objective: To conduct a questionnaire survey to analyze the knowledge of unilateral biportal endoscopy(UBE) among orthopedic surgeons, and the role of previous surgical experience of arthroscopy, percutaneous endoscopic lumbar discectomy(PELD) and open surgery when acquiring the UBE technique. Methods: Electronic questionnaires were distributed to professional seminar group,case exchange group for physicians and individual surgeons in China during 1 st to 30 th June 2021 through Wechat platform to assess their surgical experiences, treatment-of-choice for different diseases, evaluation of technical difficulties and their estimation of future proportions of surgical types among all spine surgeries. Questionnaire respondent was active medical practitioner of department of orthopedics in hospital of different levels, who scanned QR code into electronic questionnaire interface anonymously(technical support provided by WJX platform). Results: A total of 343 valid questionnaires were collected. Among all respondents, 66.2%(227/343) reported experience in UBE, 44.3%(152/343) in arthroscopy, 94.5%(324/343) in open spinal surgeries, and 77%(264/343) in PELD. Previous surgical experiences in arthroscopy, PELD and open surgery were reported helpful in improving familiarity of practice, navigation during surgery, identifying anatomical structures and converting surgical concepts when acquiring the UBE technique. PELD was chosen as the preferred procedure for simple disc herniation in 77.8%(267/343) of all respondents, while UBE was preferred when performing simple decompression for spinal stenosis in 75.2%(258/343) respondents. For patients with spinal stenosis and spinal instability that required internal fixation,52.5%(180/343) of the respondents preferred UBE to other techniques during the surgery. Statistical results showed that PELD and UBE experiences had significant effects on the operators’ surgical choices. Conclusions: Previous surgical experience in arthroscopy,PELD and open surgery is crucial in acquiring the U

关 键 词：脊柱微创手术 单侧双通道脊柱内镜 手术经验 学习曲线 问卷调查 

分 类 号：R681.5[医药卫生—骨科学]