超声联合脊柱CT/MRI定位用于脊柱畸形SMA患者腰椎穿刺术的价值  

Value of application of combined ultrasound and spinal CT/MRI-assisted lumbar puncture in spinal muscular atrophy patients with spinal deformities

作　　者：罗剑刚[1] 任飞[1] 白念岳[1] 杨胜辉[1] 王锷[1] Luo Jiangang;Ren Fei;Bai Nianyue;Yang Shenghui;Wang E(Department of Anesthesiology,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院麻醉科,长沙410008

出　　处：《中华麻醉学杂志》2022年第10期1228-1232,共5页Chinese Journal of Anesthesiology

基　　金：湖南省自然科学基金(2021JJ31091)。

摘　　要：目的探讨超声联合脊柱电子计算机断层扫描(CT)/磁共振成像(MRI)定位用于脊柱畸形脊髓性肌萎缩症(SMA)患者腰椎穿刺术的价值。方法2021年11月至2022年9月行诺西那生钠鞘内注射的SMA患者12例,根据脊柱影像学对SMA患者腰椎穿刺的困难程度进行分级,然后根据不同穿刺困难分级设计不同的穿刺方法,统计腰椎穿刺成功率、准备时间、穿刺时间、尝试次数以及并发症的发生情况。结果对12例SMA患者共进行腰椎穿刺48次,成功率100%。穿刺平均准备时间13.60 min,平均穿刺时间4.96 min,平均尝试次数1.33次。未发生脊髓、神经和脏器损伤等并发症。结论超声联合脊柱CT/MRI定位用于脊柱畸形SMA患者腰椎穿刺术的价值较高。Objective To investigate the value of application of combined ultrasound and spinal CT/MRI-assisted lumbar puncture in spinal muscular atrophy(SMA)patients with spinal deformities.Methods Twelve SMA patients with spinal deformities were evaluated for combined ultrasound and spinal CT/MRI imaging-assisted lumbar intrathecal administration of nusinersen between November 2021 and September 2022.The degree of difficulty of lumbar puncture in SMA patients was graded according to the spinal imaging,and then different puncture methods were designed according to different puncture difficulty grades.The success rate,preparation time,operation time,the number of attempts,and complications of lumbar puncture were counted.Results In this study,48 lumbar punctures were performed in 12 patients with SMA,with a success rate of 100%.The average preparation time for puncture was 13.60 min,the average puncture time was 4.96 min,and the average number of attempts was 1.33.No complications such as injury to the spinal cord,nerve and viscera were found in all patients.Conclusions Combined ultrasound and spinal CT/MRI-assisted lumbar puncture has high value when applied for SMA patients with spinal deformities.

关 键 词：超声检查 脊柱 体层摄影术 肌萎缩 脊髓性 脊椎穿刺 

分 类 号：R614[医药卫生—麻醉学]