实时三维双平面超声引导经皮腰椎间孔穿刺的临床研究  

Clinical Study of Bi-Planar Ultrasound-Guided Percutaneous Lumbar Intervertebral Foramen Punctu

作　　者：毛译 陶宇洪 张超[1] 黄鹏[2] 张明博[1] Mao Yi;Tao Yuhong;Zhang Chao;Huang Peng;Zhang Mingbo(Department of Ultrasound,The First Medical Center,General Hospital of Chinese PLA,Beijing 100039,China;Department of Orthopedics,The Fourth Medical Center,General Hospital of Chinese PLA,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心超声诊断科,北京市100039 [2]解放军总医院第四医学中心骨科,北京市100853

出　　处：《中国超声医学杂志》2025年第3期321-324,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 建立实时三维双平面超声(US)引导腰椎间孔穿刺(LIFP)方法,与X线比较准确度及安全性。方法 前瞻性纳入需行LIFP患者,分为US和X线组,比较两组穿刺过程参数,并通过累积和分析拟合US组学习曲线。结果 共68例患者,年龄(51.4±15.4)岁,男性36例,US和X线组各34例。US组学习曲线拐点为第12次穿刺。US组穿刺调整次数[0(0,1) vs. 1(0,2),P=0.040]、透视次数[1(1,2) vs. 2(2,3),P=0.001]低于X线组,穿刺信心[3(3,3) vs. 3(2,3),P=0.007]高于X线组。结论 双平面US为LIFP提供了一种实时、无辐射的引导手段,与X线相比具有更高的准确度和安全性。Objective To establish a real-time three-dimensional bi-planar ultrasound(US)guided lumbar inter-vertebral foramen puncture(LIFP)method,and compare its accuracy and safety with X-ray.Methods Patients re-quiring LIFP were prospectively enrolled and divided into US and X-ray group.The differences of the puncture process parameters were compared between two groups.The learning curve of US group was fitted using cumulative sum.Results A total of 68 patients(age 51.4±15.4 years,36 males)were balanced across US and X-ray groups.The in-flection point of the learning curve in US group was the 12th.The frequency of puncture adjustment[0(O,1)vs.1(0,2),P=0.040],frequency of fluoroscopy apply[1(1,2)vs.2(2,3),P=0.001]and the confidence score[3(3,3)vs.3(2,3),P=0.007] were statistically different between two groups.Conclusions sBi-planarUSprovides a re-al-time,radiation-free image guidance method for LIFP,which increases the accuracy and safety compared to X-ray guidance.

关 键 词：腰椎间孔穿刺 实时三维超声 双平面 学习曲线 安全性 

分 类 号：R47[医药卫生—护理学]