北京生物医学工程

一种腰椎手术体表透视定位架的研制与应用

Development and application of a fluoroscopicpositioning frame for lumbar spine surgery

作者：唐文君

单位：北京积水潭医院设备科(北京100035) 通信作者:唐文君。 E-mail: twj752@ sina. com <p> </p>

关键词：腰椎手术;X线;透视;定位架

分类号：R318.6 <p> </p>

出版年·卷·期（页码）：2021·40·6（618-621）

摘要：

目的为了准确定位腰椎前后路手术术前手术切口，减少定位时间和X射线透视次数，研制一种用于腰椎手术的体表透视定位架,并评估其应用效果。方法设计一种定位架。自2018年5月至2020年1月，将北京积水潭医院脊柱外科的采用斜外侧椎间融合术(oblique lumbar interbody fusion, OLIF)方法进行手术的52例患者分为两组,分别使用定位架法和克氏针法进行术前定位，其中定位架组27例，克氏针组25例，对两组患者的定位时间、透视次数和定位准确率进行比较分析。结果定位架组与克氏针组的定位时间分别为(1.92±0. 68)min、(3. 87± 1.56) min；透视次数分别为(2.53±1.21)次、 (4. 78±1, 57)次;两组的定位时间、透视次数差异有统计学意义(P<0. 05)。定位准确率分别为97. 2%、 94. 6%,差异无统计学意义(P>0.05)。结论此种透视定位架具有操作方便、定位准确、节省定位时间和透视次数的特点，具有推广应用的价值。

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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