经皮椎间孔镜下行腰椎间盘摘除术并发症的相关分析及其预防处理

摘要

目的 探讨经皮椎间孔镜下行腰椎间盘摘除术并发症的相关因素及预防、处理方式.方法 选取腰椎间盘突出症105例为研究对象,均行经皮椎间孔镜下行腰椎间盘摘除术治疗,观察患者并发症发生情况,并对相关因素予以分析.结果 105例患者共出现8例并发症,并发症发生率为7.62%,其中神经损伤2例(1.90%)、硬脊膜撕裂1例(0.95%)、椎间盘炎1例(0.95%)、术区出血3例(2.86%)、术后复发1例(0.95%);经Person相关性分析显示,手术时间、术中组织损伤范围同并发症发生率呈正相关性(r=0.528、0.823,均P<0.05),术者年资、术后监测时间同并发症发生率呈负相关性(r=-0.319、-0.479,均P<0.05).结论 经皮椎间孔镜下行腰椎间盘摘除术后存在并发症发生风险,其相关影响因素较多,手术应当严格掌握适应证,熟练掌握操作技巧,减少术中损伤,尽量缩短手术时间,做好并发症预后及处理.%Objective To explore the relevant factors,prevention and treatments of the complications of lum-bar intervertebral disc herniation treated with percutaneous endoscopic lumbar discectomy.Methods 105 cases of lum-bar intervertebral disc herniation underwent percutaneous endoscopic lumbar discectomy were enrolled as research sub -jects.The complications were observed and the relevant fators were analysed.Results There were 8 complications (7.62%)in 105 cases.Among them,2 cases had nerve injury(1.90%),1 case had dural tear(0.95%),1 case had Intervertebral disc inflammation(0.95%),3 cases had local hemorrhage(2.86%)and 1 case had postoperative recur-rence(0.95%).Person correlation analysis showed that the incidence of complications were positively correlated with the operative time,the extent of tissue injury(r=0.528,r=0.823,P<0.05)and negatively correlated with the surgeon experience,the postoperative monitoring time(r=-0.319,r=-0.479,P<0.05).Conclusion There is a risk of complications of lumbar interverteral disc herniation treated with percutaneous endoscopic lumbar discectomy and there are many relevant factors.Therefore,we should grasp the indications strictly,master the operation skillfully,reduce the intraoperative injury,shorten the operation time and do well in the prognosis and treatments of complications.