超声骨刀与磨钻在长节段颈椎板切除术中的对比研究

常再平，王林

（1.陕西省渭南市第二医院外四科，陕西 渭南，714000；2.新疆博湖县人民医院外科，新疆 巴音郭楞州，841400）

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摘要：

目的 对比超声骨刀与磨钻在长节段颈椎板切除术中的有效性与安全性。方法 回顾性研究2015年1月至2016年7月分别使用超声骨刀行长节段颈椎板切除术35例，磨钻行长节段颈椎板切除术67例的临床资料。对比分析两组手术节段、 手术时间、术中出血量、JOA评分、相关并发症发生率等指标。结果 磨钻组（B组）与超声骨刀组（A组）患者的年龄、性别、手 术节段、体重指数比较，无统计学差异（P>0.05）；磨钻组与超声骨刀术中出血量、手术时间分别为（244.8±39.5）mL和（200.9± 27.7）mL、（173.9±9.3）min和（152.6±11.7）min，超声骨刀组明显优于磨钻组（P<0.05）；两组患者术后JOA评分均优于术前（P<0.05）， 神经功能得到明显改善，但两组术后JOA评分比较，差异无统计学意义（P>0.05）；术中，磨钻组出现2例硬膜撕裂，两组均未 出现其他严重的并发症。结论 超声骨刀在颈后路椎板切除术中的应用是安全有效的，并且在术中出血及手术时间方面更优。

关键词：颈椎；椎板切除术；超声骨刀；磨钻

中图分类号：R687.3文献标志码：A文章编号：2096-1413(2017)07-0011-03

Comparison of ultrasonic osteotome and high-speed drill in the

operation of long segment cervical laminectomy
CHANG Zai-ping 1, WANG Lin 2
（1. the Forth Department of the Second Hospital of Weinan in Shaanxi, Weinan 714000; 2. Surgery Department of Xinjiang Hubo County People's Hospital, Bayin Prefecture 841400, China)

ABSTRACT：Objective To compare the safety and reliability of ultrasonic osteotome and high-speed drill in the operation
of long segment cervical laminectomy. Methods Retrospectively study the data of cases from January 2015 to July 2016, of which 35 cases were used ultrasonic osteotome of long segment cervical laminectomy, 67 cases were used high-speed drill. The operation segment, operation time, intraoperative blood loss, JOA score, the incidence of related complications and other indicators in the two groups were compared and analyzed. Results There were no significant differences in the age, sex, segment and body mass index between the high-speed drill group and the ultrasonic osteotome group (P>0.05);the blood loss, the operation time of the high-speed drill group and the ultrasonic osteotome group were (244.8±39.5) mL and（200.9±27.7）mL,(173.9±9.3）min and（152.6±11.7）min respectively, ultrasonic osteotome group was significantly better than the high -speed drill group (P <0.05); postoperative JOA scores in the two groups were better than those before operation (P<0.05); neurological function was significantly improved, the difference of postoperative JOA score in the two groups was not statistically significant (P>0.05); only two patients had dural tear in ultrasonic osteotome group. There wereno serious complications in the two groups. Conclusion Ultrasonic osteotome is safe and reliable for the operation of long segment cervical laminectomy，and has better performance in intraoperative bleeding and operative time.

KEYWORDS：cervical vertebrae; laminectomy; ultrasonic osteotome; drill

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