中华医学超声杂志（电子版）
中華醫學超聲雜誌（電子版）
중화의학초성잡지（전자판）
CHINESE JOURNAL OF MEDICAL ULTRASOUND(ELECTRONICAL VISION)
2010年
12期
2139-2144
,共6页
杨万石%赵小魁%王强%杨敬%邵楠%陈茁%黄曼维
楊萬石%趙小魁%王彊%楊敬%邵楠%陳茁%黃曼維
양만석%조소괴%왕강%양경%소남%진촬%황만유
超声检查%手术中监测%脊柱脊髓手术
超聲檢查%手術中鑑測%脊柱脊髓手術
초성검사%수술중감측%척주척수수술
Ultrasonography%Intraoperative monitoring%Vertebral and spinal cord operation
目的 探讨超声在脊柱脊髓手术过程中实时监测脊髓形态图像特征及其临床应用价值.方法 对19例脊柱脊髓手术患者手术过程中行脊髓形态超声监测,采用JOA 评分,对术前、术后出院时、术后6个月、12个月随访JOA 评分,进行疗效评定.结果 19例术中超声监测均无脊髓损伤症状等并发症发生,无内植物松动、断裂发生,均获骨性融合.术前、出院时、术后6个月及术后1年JOA评分分别为(8.80±1.60)分、(14.00±1.57)分、(14.60±1.61)分及(14.80±1.58)分;出院时、术后6个月及术后1年JOA改善率分别为51.6%、61.3%及 64.5%;与术前评分比较,术后不同时间随访,JOA 评分分值均明显高于术前评分,差异有统计学意义(P＜0.05).术后颈椎管矢状径明显扩大(平均矢状径扩大6.6 mm),与术前比较差异有统计学意义(P＜0.05).结论 在急救创伤脊柱脊髓抢救手术中超声实时脊髓形态监测可及时了解脊髓形态改变及脊髓压迫解除情况,为临床医师提高手术效率,避免医源性脊髓损伤,提供影像学依据.
目的 探討超聲在脊柱脊髓手術過程中實時鑑測脊髓形態圖像特徵及其臨床應用價值.方法 對19例脊柱脊髓手術患者手術過程中行脊髓形態超聲鑑測,採用JOA 評分,對術前、術後齣院時、術後6箇月、12箇月隨訪JOA 評分,進行療效評定.結果 19例術中超聲鑑測均無脊髓損傷癥狀等併髮癥髮生,無內植物鬆動、斷裂髮生,均穫骨性融閤.術前、齣院時、術後6箇月及術後1年JOA評分分彆為(8.80±1.60)分、(14.00±1.57)分、(14.60±1.61)分及(14.80±1.58)分;齣院時、術後6箇月及術後1年JOA改善率分彆為51.6%、61.3%及 64.5%;與術前評分比較,術後不同時間隨訪,JOA 評分分值均明顯高于術前評分,差異有統計學意義(P＜0.05).術後頸椎管矢狀徑明顯擴大(平均矢狀徑擴大6.6 mm),與術前比較差異有統計學意義(P＜0.05).結論 在急救創傷脊柱脊髓搶救手術中超聲實時脊髓形態鑑測可及時瞭解脊髓形態改變及脊髓壓迫解除情況,為臨床醫師提高手術效率,避免醫源性脊髓損傷,提供影像學依據.
목적 탐토초성재척주척수수술과정중실시감측척수형태도상특정급기림상응용개치.방법 대19례척주척수수술환자수술과정중행척수형태초성감측,채용JOA 평분,대술전、술후출원시、술후6개월、12개월수방JOA 평분,진행료효평정.결과 19례술중초성감측균무척수손상증상등병발증발생,무내식물송동、단렬발생,균획골성융합.술전、출원시、술후6개월급술후1년JOA평분분별위(8.80±1.60)분、(14.00±1.57)분、(14.60±1.61)분급(14.80±1.58)분;출원시、술후6개월급술후1년JOA개선솔분별위51.6%、61.3%급 64.5%;여술전평분비교,술후불동시간수방,JOA 평분분치균명현고우술전평분,차이유통계학의의(P＜0.05).술후경추관시상경명현확대(평균시상경확대6.6 mm),여술전비교차이유통계학의의(P＜0.05).결론 재급구창상척주척수창구수술중초성실시척수형태감측가급시료해척수형태개변급척수압박해제정황,위림상의사제고수술효솔,피면의원성척수손상,제공영상학의거.
Objective To explore the value of monitoring in vertebral and spinal cord operation by the real-time monitoring of the spinal cord in the process of operation.Methods Nineteen cases were included by the real-time monitoring of spinal cord in the process of operation.Japanese Orthopaedic Association(JOA) score was used to evaluate the clinical efficacy during following-up before and discharge after operation,6 months and 12 months after operation.Results Intraoperative ultrasound monitoring in the 19 patients had no symptom of spinal cord injury and other complications within the plant without loosening fracture occurred were bony fusion; the average JOA scores in the patients before operation,discharge after operation,6 months and 12 months after operation were 8.80±1.60,14.00±1.57,14.60±1.61 and 14.80±1.58,respectively.The improvement rate of JOA score for discharge after operation,6 months and 12 months after operation were individually 51.6%,61.3%,and 64.5%.The JOA score after operation was obviously higher than that before operation.The significant difference between the two groups was observed in the experiment (P<0.05).The cervical spinal canal sagittal diameter significantly increased after operation (mean sagittal diameter of the expansion of 6.6 mm),compared with that before the trial (P<0.05).Conclusion The real-time monitoring with ultrasonography during operation can identify the change of spinal cord and provide the image evidence of operative efficiency to avoid the injury in vertebral and spinal cord operation.
