电视胸腔镜下微创脊柱侧弯前路松解术的初期临床结果  

The Preliminary Clinical Results of Anterior Release of Scoliosis with Video-assisted Thoracoscopic Technique

作　　者：王斌[1] 邱勇[1] 朱丽华[1] 吕锦瑜[1] 俞杨[1] 朱泽章[1] 

机构地区：[1]南京大学医学院附属鼓楼医院脊柱外科,南京210008

出　　处：《南京大学学报（自然科学版）》2003年第2期272-276,共5页Journal of Nanjing University（Natural Science）

摘　　要：　探讨电视胸腔镜在严重脊柱侧弯前路松解中的应用价值,并对其初期临床结果进行分析.2001年11月-2002年8月,共11例严重脊柱侧弯患者接受电视胸腔镜下前路松解,均为女性,特发性胸椎脊柱侧弯,年龄14～17岁.冠状面Cobb角90°～100°,Risser征+++～++++,松解范围T5～T12,松解节段5～7.术后行牵引二周再行后路TSRH矫形内固定术.术中出血量为100～150mL,手术时间180～220min,术后引流量520～650mL,引流时间48～96h,二期后路手术矫正率平均为58%.电视胸腔镜下脊柱侧弯的前路松解在不影响矫形手术效果的同时,能减少组织损伤,降低感染可能,减轻术后疼痛,缩短病人的康复时间.This paper evaluates the video_assisted thoracoscopic surgery (VATS) in the anterior release of severe scoliosis, and reports the clinical results compared with those of the classical open thoracotomy. From November 2001 to June 2002, 11 cases with severe scoliosis underwent the anterior release with VATS techique. The patients' age ranged from 14 to 17 years. All the patients suffered from Adolescent Idiopathic Scoliosis (AIS) with the Cobb's ranging from 90°～100°,and Risser score ranging from 3～4. The released segment were from T5 to T12. Two weeks later, the posterior correction and fixation with TSRH instrumentation were performed. The estimated blood loss during surgery was from 100～150 mL. And the total operation length was 180～220 min; the chest tube output was 520～650 mL; the thorax drainage withdrew 2～4 days after surgery. The mean correction rate of the second stage posterior surgery was 58%. The thoracoscopic technique is a safe and effective alternative to open thoracotomy in the approach to the anterior thoracic spine for the treatment of AIS. In comparison with the classical open thoracotomy, thoracoscopic spine release minimizes the tissue trauma, resulting in rapid recovery, less pain and decreased possibility of infection.

关 键 词：电视胸腔镜 初期临床结果 脊柱侧弯 前路松解术 微创外科手术 脊柱畸形 

分 类 号：R682.3[医药卫生—骨科学]