经皮椎间孔镜下髓核摘除术的常见短期并发症的病因分析及处理对策

摘要

Objective To discuss the familiar short term complications of percutaneous endoscopic lumbar discectomy (PELD),calculate the inception rate,analyze the etiological factors and generalize the therapeutic measure.Methods The clinical data of 142 patients with lumbar disc herniation who received PELD in our hospital from August 2014 to August 2016 were retrospectively analyzed.The short term complications of PELD was analyzed,the cause and disposal principle were summarized.Results 11 cases (7.7％) occurred short term complications,included 1 case nerve root injury(0.7％);1 case endorachis laceration(0.7％);1 case discitis(0.7％);2 cases transoperative bleeding bring on the changing of the surgical program(1.4％);2 case bleeding to cease operation(1.4％);4 cases inexhaustive decompression(2.8％).Conclusions In order to implement PELD effectively,the operator shall operate carefully.The experience of operator and the methods are the affinitive factors for the operation effect and the occurrence of the complicated diseases.%目的 探讨经皮椎间孔镜手术治疗腰椎间盘突出症中的常见短期并发症,统计其发生率、分析发生原因、总结处置措施.方法 回顾我院2014-08-2016-08间进行的经皮椎间孔镜腰椎间盘髓核摘除术共142例,统计本组病例出现的各种手术相关短期并发症,总结病因及处置原则.结果 共出现各类短期并发症11例,占总数7.7％.其中神经根损伤1例(0.7％);硬脊膜撕裂1例(0.7％);椎间盘炎1例(0.7％),出血致更改术式2例(1.4％),因疼痛不耐受中止手术2例(1.4％),减压不彻底4例(2.8％).结论 椎间孔镜下髓核摘除术手术操作中需仔细轻柔操作,手术效果、并发症的出现与术者经验及操作手法密切相关.