北京生物醫(yī)學(xué)工程

一種腰椎手術(shù)體表透視定位架的研制與應(yīng)用

Development and application of a fluoroscopicpositioning frame for lumbar spine surgery

作者：唐文君

單位：北京積水潭醫(yī)院設(shè)備科(北京100035) 通信作者:唐文君。 E-mail: twj752@ sina. com <p> </p>

關(guān)鍵詞：腰椎手術(shù);X線;透視;定位架

分類號：R318.6 <p> </p>

出版年·卷·期（頁碼）：2021·40·6（618-621）

摘要：

目的為了準(zhǔn)確定位腰椎前后路手術(shù)術(shù)前手術(shù)切口，減少定位時間和X射線透視次數(shù)，研制一種用于腰椎手術(shù)的體表透視定位架,并評估其應(yīng)用效果。方法設(shè)計(jì)一種定位架。自2018年5月至2020年1月，將北京積水潭醫(yī)院脊柱外科的采用斜外側(cè)椎間融合術(shù)(oblique lumbar interbody fusion, OLIF)方法進(jìn)行手術(shù)的52例患者分為兩組,分別使用定位架法和克氏針法進(jìn)行術(shù)前定位，其中定位架組27例，克氏針組25例，對兩組患者的定位時間、透視次數(shù)和定位準(zhǔn)確率進(jìn)行比較分析。結(jié)果定位架組與克氏針組的定位時間分別為(1.92±0. 68)min、(3. 87± 1.56) min；透視次數(shù)分別為(2.53±1.21)次、 (4. 78±1, 57)次;兩組的定位時間、透視次數(shù)差異有統(tǒng)計(jì)學(xué)意義(P<0. 05)。定位準(zhǔn)確率分別為97. 2%、 94. 6%,差異無統(tǒng)計(jì)學(xué)意義(P>0.05)。結(jié)論此種透視定位架具有操作方便、定位準(zhǔn)確、節(jié)省定位時間和透視次數(shù)的特點(diǎn)，具有推廣應(yīng)用的價值。

Objective In order to accurately locate the surgical incision,reduce the positioning time and the number of X-ray fluoroscopy, the author develop a fluoroscopy positioning frame for lumbar spine surgery, and evaluate its application effect. Methods The author designed a metal positioning frame. From May 2018 to January 2020,52 patients in Department of Spinal Surgery, Beijing Jishuitan Hospital who were operated on with oblique lumbar interbody fusion ( OLIF) , were divided into two groups, the methods of positioning frame and Kirschner wire were used respectively on the two groups, including 27 cases in the positioning frame group and 25 cases in the Kirschner wire group. The positioning time, the number of fluoroscopy and the positioning accuracy of the two groups of patients were compared and analyzed. Results The positioning time of the positioning frame group and the Kirschner wire group were ( 1. 92±0. 68) min and ( 3. 87± 1. 56) min； the number of fluoroscopy was ( 2. 53± 1. 21) times and(4. 78± 1. 57) times,respectively. The differences in the positioning time and the number of fluoroscopy between the two groups were statistically significant (P<0. 05). The positioning accuracy rates were 97. 2% and 94. 6%, respectively, and the difference was not statistically

significant ( P > 0. 05 ). Conclusions The fluoroscopic positioning frame has characteristics of convenient operation,accurate positioning and saving positioning and fluoroscopy time, and has a value of popularization and application.

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