网格状定位器在青壮年腰椎间盘突出症经皮椎间孔镜技术中的应用  

Application of grid-like locator in percutaneous transforaminal endoscopic discectomy for lumbar disc hernia⁃tion in young adults

作　　者：罗盛中 张国福[2] 程细高[1] LUO Sheng-zhong;ZHANG Guo-fu;CHENG Xi-gao(Department of Orthopedics,Second Affiliated Hospital of NanchangUniversity,Nanchang Jiangxi 330000,China;Department of Orthopedics and Traumatology,Affiliated Hospital of Traditional ChineseMedicine,Jiangxi University of Chinese Medicine,Nanchang Jiangxi 330000,China)

机构地区：[1]南昌大学第二附属医院骨科,江西南昌330000 [2]江西中医药大学附属中医院骨伤科,江西南昌330000

出　　处：《局解手术学杂志》2024年第9期805-809,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：国家自然科学基金项目(82060403)。

摘　　要：目的探讨网格状定位器在青壮年腰椎间盘突出症(LDH)行经皮椎间孔镜(TESSYS)技术中的应用效果。方法采用随机对照的研究方法,纳入102例青壮年LDH患者,分为对照组和观察组,每组51例。对照组患者行TESSYS技术,观察组患者行网格状定位器下TESSYS技术。比较2组患者围术期指标、并发症、手术优良率及手术前后疼痛介质[5-羟色胺(5-HT)、P物质(SP)]、Oswestry功能障碍指数(ODI)、视觉模拟评分法(VAS)、Cobb角、腰椎曲度指数。结果观察组患者手术时间短于对照组,术中出血量、术中透视次数少于对照组(P<0.05)。术后3 d观察组患者血清5-HT、SP水平及VAS评分均低于对照组(P<0.05);术后3个月、6个月、12个月2组患者血清疼痛介质、VAS评分、ODI评分、Cobb角、腰椎曲度指数比较差异均无统计学意义(P>0.05)。术后12个月,观察组与对照组患者并发症发生率(4.16%vs.10.64%)、手术优良率(89.58%vs.85.11%)比较差异均无统计学意义(P>0.05)。结论在使用TESSYS技术治疗青壮年LDH时应用网格状定位器有助于减少术中透视次数,缓解疼痛症状,缩短手术时间。Objective To investigate the application effect of grid-like locator in percutaneous transforaminal endoscopic discectomy(TESSYS)technology for lumbar disc herniation(LDH)in young adults.Methods Using a randomized controlled study method,102 young adults with LDH were included and divided into the control group and the observation group,with 51 cases in each group.Patients in the control group underwent TESSYS technology,while patients in the observation group underwent TESSYS technology with a grid-like locator.The perioperative indicators,complications,good to excellent surgical rate,the pre-and post-operative pain mediators[5-hydroxy‐tryptamine(5-HT),substance P(SP)],Oswestry disability index(ODI),visual analogue scale(VAS),Cobb angle,and lumbar curvature index were compared between the two groups.Results The operation time of patients in the observation group was shorter than that of the control group,and the intraoperative blood loss and the number of intraoperative fluoroscopy were less than those of the control group(P<0.05).The levels of serum 5-HT and SP,and VAS score 3 days after surgery in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the serum pain mediators,VAS scores,ODI scores,Cobb angles,or lumbar curvature indexes 3 months,6 months,and 12 months after surgery between the two groups(P>0.05).There was no significant difference between the observation group and the control group in the incidence of complications(4.16%vs.10.64%),good to excellent surgical rate(89.58%vs.85.11%)12 months after surgery(P>0.05).Conclusion The application of a grid-like locator in TESSYS technology for young adults with LDH can help to reduce the intraoperative fluoroscopy,alleviate pain symptoms,and shorten the operation time.

关 键 词：青壮年 腰椎间盘突出症 经椎间孔内镜脊柱系统技术 网格状定位器 C型臂机 

分 类 号：R681.5[医药卫生—骨科学]