关于应用骨科手术机器人以降低颈椎后路单开门椎管扩大成形术出血量的研究  

Research on the application of orthopedic surgical robot to reduce the blood loss during cervical posterior single-door laminoplasty

作　　者：朱文潇 崔宏勋 孔亮 刘永辉 程卫东 郑振雨 曹向阳 ZHU Wen-xiao;CUI Hong-xun;KONG Liang;LIU Yong-hui;CHENG Wei-dong;ZHENG Zhen-yu;CAO Xiang-yang(Department of Spine Surgery,Luoyang Orthopedic-Traumatological Hospital Of Henan Province(Henan Provincial Orthopedic Hospital),Zhengzhou,Henan 450018,China)

机构地区：[1]河南省洛阳正骨医院(河南省骨科医院)脊柱外科,河南郑州450018

出　　处：《颈腰痛杂志》2024年第2期340-344,共5页The Journal of Cervicodynia and Lumbodynia

基　　金：河南省中医药科学研究专项课题(编号:20-21ZY2246)。

摘　　要：目的研究在颈椎后路单开门椎管扩大成形术中,应用骨科手术机器人对术中出血量、术后引流量及隐性失血量的影响。方法将2020年8月~2021年2月该院收治的9例多节段脊髓型颈椎病患者作为研究组,在天玑骨科手术机器人辅助定位下行颈椎后路单开门椎管扩大成形术;将2019年8月至~2020年7月未使用机器人辅助下行颈椎后路单开门椎管扩大成形术的多节段脊髓型颈椎病患者15例为对照组。计算并对比两组患者手术时间、术中出血量、术后总引流量,隐性失血量、总出血量及颈椎JOA评分等指标。结果研究组患者术中出血量、隐性失血量和总出血量分别为(206.89±39.19)mL、(83.11±24.37)mL、(641.78±63.67)mL,均小于对照组的(245.73±40.55)mL、(134.60±30.54)mL、(726.07±80.69)mL,其差异具有统计学意义(P<0.05);两组手术操作时间及术后总引流量对比,无明显差异。两组患者术前JOA评分无明显差异;研究组末次随访JOA评分为(15.33±2.06)分,显著优于对照组的(13.20±2.45)分,差异有统计学意义(P<0.05)。结论应用骨科手术机器人辅助定位行颈椎后路单开门椎管扩大成形术,有利于精准定位椎管边界,快速、准确定位开门位置,利于手术操作,减少术中出血量、隐性失血量和总出血量,促进患者临床症状改善,值得推广应用。Objective To explore the clinical effect of robot navigation for posterior cervical open-door laminoplasty in order to reduce blood loss with an orthopaedic surgical robot,minimize surgical trauma and expand the application of surgical robots.Methods Nine patients with Cervical spinal stenosis that had undergone posterior cervical open-door laminoplasty with robot navigation from August 2020 to February 2021 were assigned to research group while another 15 cases that were treated without robot navigation were assigned to control group.The intraoperative blood loss,postoperative total drainage volume,hidden blood loss,total blood loss,operative time and cervical JOA score of patients were collected and compared between in the two groups.Results The intraoperative blood loss,hidden blood loss and total blood loss in the study group were(206.89±39.19)mL,(83.11±24.37)mL,(641.78±63.67)mL,respectively,which were lower than those in the control group(245.73±40.55)mL、(134.60±30.54)mL and(726.07±80.69)mL.The differences were statistically significant(P<0.05).There was no significant difference in operation time and total drainage in preoperative JOA score between the two groups.And the JOA score of the study group(15.33±2.06)was better than that of the control group(13.20±2.45)at the last follow-up,whose differences have statistical significance(P<0.05).Conclusions The application of orthopedic surgical robot assisted positioning for posterior single-door expansive spinal canal plasty is beneficial to precisely positioning of spinal canal boundary,rapidly and accurately positioning of open door position,conducive to surgical operation,reducing intraoperative blood loss,hidden blood loss and total blood loss,and promoting the improvement of clinical symptoms of patients,which is worthy of popularization and application.

关 键 词：骨科手术机器人 后路单开门手术 失血量 脊髓型颈椎病 

分 类 号：R687.3[医药卫生—骨科学]