[1]任志伟** 王莹 尹思 杨益民 张小卫.常规穿刺与导棒飘移穿刺在椎间孔镜手术中应用的比较[J].中国微创外科杂志,2018,18(11):1011-1014.
　Ren Zhiwei,Wang Ying,Yin Si,et al.Comparison of Conventional Puncture and Dilator Drift Puncture in Transforaminal Endoscopic Surgery[J].Chinese Journal of Minimally Invasive Surgery,2018,18(11):1011-1014.
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常规穿刺与导棒飘移穿刺在椎间孔镜手术中应用的比较()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年11期
页码:
1011-1014
栏目:
临床研究
出版日期:
2018-11-20

文章信息/Info

Title:
Comparison of Conventional Puncture and Dilator Drift Puncture in Transforaminal Endoscopic Surgery
作者:
任志伟** 王莹 尹思 杨益民 张小卫
（西安交通大学第一附属医院骨科，西安710061）
Author(s):
Ren Zhiwei;  Wang Ying;  Yin Si;  et al.
Department of Orthopedics, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
关键词:
腰椎间盘突出症; 椎间孔镜手术; 导棒飘移穿刺; 椎间盘切除术
Keywords:
Lumbar disc herniation; Transforaminal endoscopic surgery; Dilator drift puncture; Discectomy
文献标志码:
A
摘要:
目的探讨导棒漂移穿刺在椎间孔镜手术中的价值。方法2014年10月~2016年3月66例单节段椎间盘突出分别采用常规穿刺置管（常规组，n=36）或导棒飘移穿刺置管（导棒组，n=30），比较2组透视次数，穿刺时间和手术时间，采用视觉模拟评分法（Visual Analogue Score，VAS）、Oswestry功能障碍指数（Oswestry Disability Index，ODI）评定术后疗效。结果2组无并发症发生。常规组透视次数（18.3±4.7）次，明显多于导棒组（13.0±3.1）次（t=5461，P=0000）；穿刺时间（312±66）min，明显长于导棒组（254±50）min（t=3969，P=0000）；手术时间（719±87）min，明显长于导棒穿刺组（643±83）min（t=3639，P=0001）。2组间术前后各时点VAS评分（F=0060，P=0807）和ODI（F=0166，P=0685）比较无统计学差异。常规组内术后各时点VAS评分（F=203467，P=0000）和ODI（F=176339，P=0000）均较术前明显降低；导棒组内术后各时点VAS评分（F=103247，P=0000）和ODI（F=114642，P=0000）较术前明显降低。结论与常规穿刺相比，导棒飘移穿刺可以显著提高椎间孔镜穿刺的准确率，缩短手术时间，降低辐射风险，值得在椎间孔镜手术中推广应用。
Abstract:
ObjectiveTo explore the value of dilator drift puncture in transforaminal endoscopic surgery.MethodsSixtysix patients with single segment disc herniation treated from October 2014 to March 2016 were enrolled. Of these, 36 were treated with conventional puncture as routine puncture group, and 30 cases were used dilator drift puncture as dilator puncture group. The fluoroscopy times, puncture time and operation time between the two groups were compared, and the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were used to assess clinical outcomes.ResultsNo complications occurred in both groups. As compared to the routine puncture group, the dilator puncture group had less fluoroscopy times ［(13.0±31) times vs. (18.3±4.7) times, t=5.461, P=0.000］, shorter puncture time ［(25.4±5.0) min vs. (31.2±6.6) min, t=3.969, P=0.000］, and shorter operative time ［(64.3±8.3) min vs. (71.9±8.7) min, t=3.639, P=0.001］. There was no significant difference in VAS scores (F=0.060, P=0.807) and ODI (F=0.166, P=0.685) between the two groups before and after surgery. In the routine puncture group, the VAS scores (F=203.467, P=0.000) and ODI (F=176.339, P=0.000) at alltime points were significantly lower than before surgery. In the dilator puncture group, at each postoperative time points the VAS scores (F=103.247, P=0.000) and ODI (F=114.642, P=0.000) were also significantly lower than before surgery.ConclusionsCompared with conventional puncture, dilator drift puncture can significantly improve the accuracy of intervertebral foramen puncture, shorten the operation time, and reduce the radiation risk. It is worthy of promotion in transforaminal endoscopic surgery.

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备注/Memo

备注/Memo:
＊基金项目：国家自然科学青年基金（81602811）；陕西省自然科学基础研究项目（2017JM8168）**通讯作者，Email：zwren1980@163.com
更新日期/Last Update: 2019-03-01