本文選題：腰椎間盤(pán)突出癥　切入點(diǎn)：經(jīng)皮椎間孔鏡椎間盤(pán)切除術(shù)　出處：《中國(guó)矯形外科雜志》2017年23期 　論文類型：期刊論文

【摘要】：[目的]探討輔助椎間孔周圍浸潤(rùn)麻醉對(duì)經(jīng)皮腰椎間孔鏡髓核摘除術(shù)中鎮(zhèn)痛的療效。[方法]將64例單節(jié)段腰椎間孔鏡下髓核摘除術(shù)治療的患者隨機(jī)分為椎間孔浸潤(rùn)組和逐層浸潤(rùn)組。椎間孔浸潤(rùn)組于棘突旁開(kāi)約4 cm予0.5%利多卡因行關(guān)節(jié)突外側(cè)及椎間孔浸潤(rùn)麻醉;逐層浸潤(rùn)組采用逐層利多卡因浸潤(rùn)麻醉。記錄兩組手術(shù)時(shí)間、透視次數(shù),采用視覺(jué)模擬評(píng)分法(visual analogue scale,VAS)評(píng)估椎間孔成形及后縱韌帶處理時(shí)的疼痛,采用Likert五分量表法評(píng)價(jià)患者對(duì)局麻手術(shù)的體驗(yàn),并對(duì)再手術(shù)意愿進(jìn)行調(diào)查。[結(jié)果]椎間孔浸潤(rùn)組患者均順利完成手術(shù),逐層浸潤(rùn)組有3例術(shù)中在椎間孔成形時(shí)由于不能耐受疼痛而臨時(shí)增加靜脈強(qiáng)化鎮(zhèn)痛;兩組手術(shù)時(shí)間、透視次數(shù)差異不具有統(tǒng)計(jì)學(xué)意義(P0.05);椎間孔浸潤(rùn)組椎間孔成形VAS評(píng)分為(4.74±1.05)分,逐層浸潤(rùn)組(7.48±1.16)分,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。后縱韌帶處理時(shí)椎間孔浸潤(rùn)組VAS評(píng)分(3.74±0.62)分,逐層浸潤(rùn)組(5.22±0.80)分,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);椎間孔浸潤(rùn)組的局麻體驗(yàn)評(píng)價(jià)選擇好和很好的占75.00%,而逐層浸潤(rùn)組僅31.25%;再手術(shù)意愿椎間孔浸潤(rùn)組為87.00%,而逐層浸潤(rùn)組為46.88%,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。[結(jié)論]輔助椎間孔周圍浸潤(rùn)麻醉可以顯著減少椎間孔鏡術(shù)中的疼痛,且操作簡(jiǎn)單,安全性高。
[Abstract]:[objective] to investigate the analgesic effect of assisted periforaminal infiltration anesthesia in percutaneous lumbar foramellar nucleus pulpotomy. [methods] Sixty-four patients undergoing single segmental intervertebral foramen endoscopy were randomly divided into intervertebral foramen dipping. The intervertebral foramen infiltration group was treated with 0.5% lidocaine to anaesthesia of lateral articular process and intervertebral foramen. Laminar infiltration group was anesthetized by layer by layer lidocaine. The operation time, fluoroscopy times and visual analogue score were used to evaluate the pain of intervertebral foramination and posterior longitudinal ligament treatment. The experience of local anaesthesia was evaluated by Likert quintile scale, and the willingness of reoperation was investigated. [results] all the patients in the intervertebral foramen infiltration group completed the operation successfully. In the laminar infiltrating group, 3 cases were temporarily increased intravenous analgesia during intervertebral foramination because of their intolerable pain. There was no significant difference in the operation time between the two groups (P 0.05), and the VAS score of intervertebral foramen formation in the intervertebral foramen infiltration group was 4.74 鹵1.05). The VAS score of the intervertebral foramen infiltration group was 3.74 鹵0.62 when the posterior longitudinal ligament was treated, and 5.22 鹵0.80 in the layer by layer infiltration group. The difference was statistically significant (P 0.05), the local anesthetic experience evaluation in the intervertebral foramen infiltration group was 75.00%, while that in the layer-by-layer infiltration group was only 31.25%, and that in the intervertebral foramen infiltration group was 87.00 and 46.88, respectively. The difference was statistically significant. [conclusion] Auxiliary periforaminal infiltration anesthesia can significantly reduce the pain in intervertebral foramen surgery. And the operation is simple, the security is high.
【作者單位】： 福建醫(yī)科大附屬第二醫(yī)院骨科;
【分類號(hào)】：R614

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本文編號(hào)：1622582