自制定位引导器在椎间孔镜手术定位穿刺中的应用

Application of homemade positioning guide device in the positioning puncture of transforaminal endoscopic surgery

目的探讨自制定位引导器在椎间孔镜手术中定位穿刺的实用性以及术中操作注意事项。方法将29例腰椎间盘突出症患者根据住院日期奇、偶数分为观察组(14例,住院日期为奇数,采用自制定位引导器辅助定位穿刺下行椎间孔镜手术治疗)和对照组(15例,住院日期为偶数,依据术者经验定位穿刺下行椎间孔镜手术治疗)。记录术中透视次数、穿刺时间和调整穿刺次数。结果术中透视次数、穿刺时间、穿刺调整次数观察组均少(短)于对照组(P<0.05)。患者均获得随访,时间3~6个月。两组术后均未发生并发症,疼痛均明显缓解。结论在椎间孔镜手术中,应用自制定位引导器可提高皮肤定位点的定位准确率,缩短穿刺时间、减少透视次数,提高了手术穿刺效率。

Objective To investigate the practicability of the homemade positioning guide device in the positioning puncture of transforaminal endoscopic surgery and the intraoperative precautions.Methods According to the date of admission odd and even number,29 cases of patients with lumbar disc herniation were divided into observation group(14 cases whose admission dates were odd numbe were treated with transforaminal endoscopic surgery assisted by homemade positioning guide device)and control group(15 cases whose admission dates were even number were treated with transforaminal endoscopic surgery on the basis of operator′s experience).The times of intraoperative fluoroscopy,puncture time and adjustment times of needle puncture were recorded.Results The times of intraoperative fluoroscopy,puncture time and puncture adjustment times in the observation group were shorter than those in the control group(P<0.05).All patients were followed up for 3~6 months.There were no postoperative complications in two groups,and the postoperative pain was relieved significantly.Conclusions The homemade positioning puncture guide device can improve the positioning accuracy,shorten puncture time,and reduce fluoroscopy times,which can improve the efficiency of surgical puncture.