CT三维重建体表定位的方法在腰椎穿刺中的应用.docVIP

CT三维重建体表定位的方法在腰椎穿刺中的应用 　　【摘要】 目的：探索CT三维重建体表定位方法在腰椎间盘突出症微创介入治疗中的价值。方法：将2014-2015年在笔者所在医院确诊为腰椎间盘突出症且需经椎板间孔入路胶原酶化学溶解术的60例患者，随机分成A组和B组，每组30例。A组按既往CT平扫方法定位确定穿刺点进行椎板间孔入路穿刺，B组利用CT三维重建体表定位确定穿刺点进行操作。分析两组确定穿刺点所用时间、穿刺到位所用时间、穿刺次数及CT扫描次数。结果：定位用时分别为（1.22±0.13）min和（1.23±0.14）min，穿刺到位用时分别为（3.61±1.19）min和（2.80±0.97）min，穿刺平均次数分别为（5.42±1.02）次和（4.28±0.92）次，术中CT扫描次数分别为（4.23±0.82）次和（3.57±0.68）次，比较差异均有统计学意义（P0.05）。结论：将CT三维重建体表定位方法用于经椎板间孔入路胶原酶化学溶解术，不增加体表穿刺点定位用时，明显缩短经皮穿刺到位用时、穿刺次数及术中CT扫描次数，并能最大程度减少并发症，值得临床推广。 　　【关键词】 体表定位； CT三维重建； 腰椎间盘突出症 　　中图分类号 R445.3 文献标识码 B 文章编号 1674-6805（2016）17-0044-02 　　【Abstract】 Objective：To evaluate the application of CT 3-dimensional reconstruction images and surface marks in treatment of lumbar puncture.Method：60 patients with lumbar disc disease treated by lumbar puncture from 2014 to 2015 in our hospital were randomly divided into group A and group B，30 cases in each group.The puncture point of group A was determined by conventional puncturing method，group B was determined by CT 3-dimensional reconstruction images and surface marks.The used time for puncturing point positioning and puncturing to right place，the number of puncturing times and the number of CT scanning times were recorded，and the results were compared between the two groups.Result：The used time for puncturing point positioning in group A and group B were respectively （1.22±0.13）min and （1.23±0.14）min，the used time for puncturing to the right place were respectively （3.61±1.19）min and （2.80±0.97）min，the mean number of puncturing times were respectively 4.41±1.91 and 2.23±1.09，and the number of CT scanning times for the procedure were respectively 4.23±0.82 and 3.57±0.68，there were statistically significant in the two groups（P0.05）.Conclusion：Application of CT 3-dimensional reconstructive images and surface marks in lumbar puncture will not increase the time for puncturing point positioning and can significantly save the time for puncturing to the right place.The number of puncturing times and