椎间孔镜技术新型体表定位器在经皮内镜腰椎间盘切除术中的应用

Application of a newly designed body surface-assisting puncture device in transforaminal percutaneous endoscopic lumbar discectomy

目的探讨椎间孔镜技术新型体表定位器于经皮内镜腰椎间盘切除术中应用的临床疗效。方法选择2017年8月1日至12月1日在泰安市中心医院脊柱外科因腰椎间盘突出症接受经皮内镜腰椎间盘切除术治疗的患者70例,入院时采用简单随机分组的方式分为2组,其中,定位器组35例使用新型定位器辅助穿刺,传统组35例使用传统穿刺方法。记录2组的穿刺次数、透视次数、手术时间、术后并发症并比较组间差异。结果 2组均未发生重大并发症。定位器组的平均穿刺次数为(1.89±0.57)次,传统组的平均穿刺次数为(4.34±1.67)次,2组间具有统计学差异(P<0.001)。定位器组的平均透视次数为(5.49±2.21)次,传统组的平均透视次数为(10.60±3.67)次,2组间具有统计学差异(P<0.001)。定位器组的平均手术时间为(79.31±17.96)min,传统组的平均手术时间为(91.09±18.35)min,2组间有统计学差异(P=0.008)。结论使用自主研制的新型体表穿刺定位器与使用传统穿刺方法均能取得较为理想的临床疗效。使用新型体表穿刺定位器可以显著减少穿刺次数、透视次数及手术时间。

Objective To evaluate the clinical efficacy of a newly designed trajectory-assisting puncture device in transforaminal percutaneous endoscopic lumbar discectomy(PELD).Methods Seventy patients who underwent PELD for prolapse of lumbar intervertebral disc at Spinal Surgery Department of Taian City Central Hospital fromAugust 1 to December 1,2017 were selected.They were equally and randomly divided into either a new device group or a traditional puncture group at admission.The new device group used a new device to assist the puncture,and the traditional puncture group used traditional puncture method.The times of punctures,the times of fluoroscopies,operation time,and postoperative complications of the two groups were recorded and compared.Results There was no major complications in either group.The average times of punctures was 1.89±0.57 in the new device group and 4.34±1.67 in the traditional puncture group,there was a statistical difference between them(P<0.001).The average times of fluoroscopies was 5.49±2.21 in the new device group and 10.60±3.67 in the traditional puncture group,there was a statistical difference between them(P<0.001).The average operation time was significantly shorter in the new device group than in the traditional puncture group[(79.31±17.96)min vs(91.09±18.35)min,P=0.008].Conclusion The use of both the newly designed body surface-assisting puncture device and traditional puncture method can achieve relatively ideal clinical effects.The new puncture device can significantly reduce the times of punctures and fluoroscopies,and effectively reduce the operation time.