[1]孙士清,狄镇海,谭中宝. CT在椎体成形术穿刺路径三维定位中的应用[J].介入放射学杂志,2014,(06):532-535.
 SUN Shi- qing,DI Zhen- hai,TAN Zhong- bao.. Application of preoperative CT scanning in three- dimensional positioning of puncture route for percutaneous vertebroplasty[J].journal interventional radiology,2014,(06):532-535.
点击复制

 CT在椎体成形术穿刺路径三维定位中的应用()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2014年06期
页码:
532-535
栏目:
临床研究
出版日期:
2014-07-05

文章信息/Info

Title:
 Application of preoperative CT scanning in three- dimensional positioning of puncture route for percutaneous vertebroplasty
作者:
 孙士清 狄镇海 谭中宝
Author(s):
 SUN Shi- qing DI Zhen- hai TAN Zhong- bao.
 Department of Interventional Radiology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu Province 212000, China
关键词:
 【关键词】 经皮椎体成形术 穿刺路径 三维定位 CT图像
文献标志码:
A
摘要:
 【摘要】 目的 经皮椎体成形术(PVP)前根据病变椎体的横断位和矢状位CT图像画出模拟穿刺路径、拟定手术方式,评价该方法的可行性。方法 58例椎体压缩性骨折患者(共63节椎体),PVP术前通过横断位和矢状位CT图像上应用画线法模拟穿刺路径并测量模拟穿刺参数,建立三维模拟穿刺路径以确定皮肤穿刺点和穿刺角度。模拟穿刺路径满足单侧入路条件者拟定手术行单侧入路,否则行双侧入路,观察该方法的临床疗效。采用视觉模拟评分(VAS)法分析患者术前及术后3个月疼痛缓解情况,统计学软件采用SPSS13.0,计量数据以(x ± s)表示并用配对t检验。结果 本组病例术前模拟穿刺结果显示不同椎体皮肤进针点及穿刺角度均不一致。所有患者根据术前确定的模拟穿刺路径均成功完成手术。所有椎体一次穿刺成功率为100%,其中55节椎体采用单侧入路,手术时间为(28.5 ± 5.5)min,双侧入路为8节椎体,手术时间(37.5 ± 5.5)min,术后患者的疼痛缓解率为100%,随访期间无严重并发症。结论 PVP术前通过对病变椎体的横断位和矢状位CT图像分析,可以在术前明确单、双侧椎弓根入路术式,有助于提高一次穿刺的成功率和穿刺的安全性。

参考文献/References:

 [1] 孙 钢, 张殿星. 经皮椎体成形术规范化条例[J]. 介入放射学杂志, 2004, 13: 90 - 91.
[2] 滕皋军. 经皮椎体成形术: 手术操作技术与相关问题[J]. 中国医学计算机成像杂志, 2002, 8: 125 - 129.
[3] 罗同青, 谢湘涛, 胡朝晖. 单侧椎弓根外侧入路椎体成形术治疗骨质疏松性压缩骨折的临床研究[J]. 中国现代手术学杂志, 2013, 17: 130 - 135.
[4] 何仕诚, 滕皋军, 曾水林, 等. 经皮椎体成形术的实验研究[J]. 中华放射学杂志, 2002, 36: 74 - 77.
[5] 杨智贤, 彭小忠, 武振国, 等. 胸腰椎经皮椎体成形术单侧穿刺外展角的测量[J]. 中国骨科临床与基础研究杂志, 2012, 4: 350 - 355.
[6] 狄镇海, 谭中宝, 张 建, 等. CT图像参考下单侧入路经皮椎体成形术的探讨[J]. 介入放射学杂志, 2011, 20: 548 - 551.
[7] 李洪德, 何仕诚, 张年明, 等. 改良法经皮椎体成形术治疗骨质疏松性椎体重度压缩骨折[J]. 中国介入影像与治疗学, 2010, 7: 620 - 623.
[8] He SC, Teng GJ, Deng G, et al. Repeat vertebroplasty for unrelieved pain at previously treated vertebral levels with osteoporotic vertebral compression fractures[J]. Spine (Phila Pa 1976), 2008, 33: 640 - 647.
[9] 黄 胜, 许 靖, 项禹诚, 等. 单侧与双侧入路经皮椎体成形术治疗骨质疏松压缩性骨折的比较研究[J]. 中国矫形外科杂志, 2013, 21: 115 - 118.
[10] Chung HJ, Chung KJ, Yoon HS, et al. Comparative study of balloon kyphoplasty with unilateral versus bilateral approach in osteoporotic vertebral compression fractures[J]. Int Orthop, 2008, 32: 817 - 820.
[11] 李士春, 云 才. 椎体成形术的并发症分析及预防探讨[J]. 实用骨科杂志, 2011, 17: 724 - 726.
[12] Biafora SJ, Mardjetko SM, Butler JP, et al. Arterial injury following percutaneous vertebral augmentation: a case report[J]. Spine (Phila Pa 1976), 2006, 31: E84 - E87.
[13] Lieberman IH, Dudeney S, Reinhardt MK, et al. Initial outcome and efficacy of“kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures[J]. Spine (Phila Pa 1976), 2001, 26: 1631 - 1638.
[14] 李传将. 经皮椎体成形术骨水泥渗漏研究近况[J]. 医学综述, 2010, 16: 2993 - 2997.

相似文献/References:

[1]张 琳,黄学全,王健,等.自主研发电化学治疗同轴电极与传统针式电极电解效应的对比研究[J].介入放射学杂志,2012,(02):148.
 ZHANG Lin,HUANG Xue-quan,WANG Jian,et al.The electrolytic effect in electrochemotherapy: a comparative study between self-prepared coaxial electrode and conventional needle electrode[J].journal interventional radiology,2012,(06):148.
[2]赵 玮,王伟中,陈莹,等.耳部动静脉畸形供血动脉的血管造影研究[J].介入放射学杂志,2012,(02):103.
 ZHAO Wei,WANG Wei-zhong,CHEN Ying,et al.Angiographic findings of the feeding arteries of auricular arteriovenous malformations[J].journal interventional radiology,2012,(06):103.
[3]邹俊民,龙世娟,张振明. 改良髂内动脉化疗联合放疗治疗Ⅲ~Ⅳa期 子宫颈癌32例[J].介入放射学杂志,2012,(02):123.
 ZOU Jun-min,LONG Shi-Juan,ZHANG Zheng-ming..Improved internal iliac artery chemotherapy combined with radiotherapy for the treatment of stage Ⅲ-Ⅳa cervical cancers[J].journal interventional radiology,2012,(06):123.
[4]王昌明,李 选,宋世兵,等.肝门部胆道引流管折叠技术在肝移植后胆道非吻合口狭窄治疗中的应用[J].介入放射学杂志,2012,(02):136.
 WANG Chang-ming,LI Xuan,SONG Shi-bing,et al.The application of biliary catheter folding technique in the treatment of hilar nonanastomotic biliary strictures after orthotopic liver transplantation[J].journal interventional radiology,2012,(06):136.
[5]赵玉峰,孙玉琴,韩晓静,等. 输卵管介入再通术后受孕时机的研究[J].介入放射学杂志,2012,(02):158.
 ZHAO Yu-feng,SUN Yu-qin,HAN Xiao-jing,et al.The optimal time for conception after fallopian tube recanalization therapy[J].journal interventional radiology,2012,(06):158.
[6]含 笑,曹建民,史东宏,等.吉西他滨、顺铂动静脉联合化疗治疗晚期非小细胞肺癌的近期疗效分析[J].介入放射学杂志,2012,(02):119.
 HAN Xiao,CAO Jian-min,SHI Dong-hong,et al.Bronchial artery infusion of Gemcitabine and Cisplatin combined with systemic chemotherapy for advanced non-small cell lung cancer: its short-term efficacy[J].journal interventional radiology,2012,(06):119.
[7]姚雪松,李 槐.不可手术切除的肝细胞癌的疗效评价标准——改良RECIST标准更可靠[J].介入放射学杂志,2012,(03):177.
 . Therapeutic evaluation criterion of inoperable hepatocellular carcinomas: modified RECIST as a more reliable standard[J].journal interventional radiology,2012,(06):177.
[8]齐 立,李慎茂,俸军林,等. 动脉溶栓与机械碎栓联合动脉溶栓的对比分析[J].介入放射学杂志,2012,(03):180.
 ,,et al. Comparison of the therapeutic efficacy between simple arterial thrombolysis and mechanical thrombectomy combined with arterial thrombolysis for acute cerebral infarction at its ultraearly stage[J].journal interventional radiology,2012,(06):180.
[9]石 潆,赵 卫,沈 进,等.脑动静脉畸形栓塞治疗术并发颅内出血的原因及处理[J].介入放射学杂志,2012,(03):185.
 ,,et al.Intracranial hemorrhage due to embolization therapy for cerebral arteriovenous malformation: its causes and management [J].journal interventional radiology,2012,(06):185.
[10]周 慷,李晓光,金征宇,等.清宫术前子宫动脉化疗栓塞术治疗瘢痕妊娠的疗效分析[J].介入放射学杂志,2012,(03):190.
 ,,et al.Therapeutic analysis of bilateral uterine artery chemoembolization performed before uterine dilation and curettage for cesarean scar pregnancy [J].journal interventional radiology,2012,(06):190.
[11]肖全平,吴春根,顾一峰,等. 经皮椎体成形术治疗脊椎转移性肿瘤的研究进展[J].介入放射学杂志,2013,(10):872.
 XIAO Quan? ping,WU Chun? gen,GU Yi? feng,et al. Percutaneous vertebroplasty for the treatment of spinal metastases: recent progress in research[J].journal interventional radiology,2013,(06):872.
[12]徐云华,倪才方,陈 珑,等.经皮椎体成形术治疗不同类型疼痛性脊柱转移癌[J].介入放射学杂志,2014,(02):122.
 XU Yun? hua,NI Cai? fang,CHEN Long,et al. Percutaneous vertebroplasty for the treatment of painful metastatic spinal lesions of different types[J].journal interventional radiology,2014,(06):122.

备注/Memo

备注/Memo:
 (收稿日期:2013-12-28)
更新日期/Last Update: