[1]刘晓强 王洪伟** 段洪凯 李铠湘 钟章华 谷昌伟.腰椎间孔镜不良事件原因分析[J].中国微创外科杂志,2020,01(4):330-334.
　Liu Xiaoqiang,Wang Hongwei,Duan Hongkai,et al.Reason Analysis of Adverse Events of Percutaneous Endoscopic Lumbar Discectomy[J].Chinese Journal of Minimally Invasive Surgery,2020,01(4):330-334.
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腰椎间孔镜不良事件原因分析()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2020年4期
页码:
330-334
栏目:
临床研究
出版日期:
2020-04-25

文章信息/Info

Title:
Reason Analysis of Adverse Events of Percutaneous Endoscopic Lumbar Discectomy
作者:
刘晓强 王洪伟** 段洪凯 李铠湘 钟章华 谷昌伟
(中山大学附属东华医院东莞东华医院脊柱外科，东莞523110)
Author(s):
Liu Xiaoqiang;  Wang Hongwei;  Duan Hongkai;  et al.
Department of Spinal Surgery, Dongguan Tungwah Hospital, Dongguan 523110, China
关键词:
椎间孔镜; 并发症; 腰椎间盘突出症; 腰椎管狭窄症
Keywords:
Percutaneous endoscopic lumbar discectomy; Complication; Lumbar disc herniation; Lumbar spinal stenosis
文献标志码:
A
摘要:
目的分析腰椎间孔镜技术不良事件的原因。方法回顾性分析2015年3月～2018年3月椎间孔镜179例资料，16例共发生不良事件19例次(10.6%)，其中Ⅱ级事件1例(神经根损伤)，Ⅲ~Ⅳ级事件18例(硬膜囊撕裂3例，类脊髓高压综合征3例，椎间盘突出复发4例，术中减压不充分2例，导丝断裂1例，术后形成椎间盘囊肿1例，中转开放手术4例)。结果随访12～30个月，(15.2±1.2)月，除1例神经根损伤无恢复外，余均恢复。结论椎间孔镜治疗腰椎疾患初期有一定的不良事件发生率，良好清晰的镜下解剖结构、开放手术的经验、规范的培训以及术中及时的备选方案是防止不良事件发生、发挥椎间孔镜优势的关键。
Abstract:
ObjectiveTo summarize the causes of adverse events of percutaneous endoscopic lumbar discectomy (PELD) for lumbar degenerative diseases.MethodsA retrospective analysis was conducted on clinical data of 179 patients who underwent PELD from March 2015 to March 2018 in our hospital. A total of 19 adverse events occurred in 16 cases, with an incidence of 10.6% (19/179). Among them, 1 case had grade Ⅱ adverse events (nerve root injury), and 18 patients had grade Ⅲ-Ⅳ adverse events (3 cases of dural laceration, 3 cases of myelopathy hypertension syndrome, 4 cases of postoperative recurrence, 2 cases of insufficient decompression, 1 case of broken guidewire, 1 case of postoperative discal pseudocyst after lumbar discectomy, and 4 cases of conversion to open surgery).ResultsThe patients were followed up for 12-30 months, with an average of (15.2±1.2) months. All the patients recovered except one case of nerve root injury.ConclusionThere is a certain incidence of adverse events in the early stage of PELD. The key to prevent adverse events is to have a good clear anatomical structure under the microscope, rich experience in open surgery, standard training, and timely intraoperative alternatives.

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备注/Memo

备注/Memo:
基金项目：广东省自然科学基金(2017A030313894)**通讯作者，Email：1776940277@qq.com
更新日期/Last Update: 2020-07-14