摘要
目的分析胸腔镜辅助胸椎前路手术并发症发生的类型和原因,探讨其防治方法。方法回顾性分析1998年10月至2004年8月间各类胸椎疾病患者182例,手术方式包括胸腔镜锁孔和小切口技术,病灶清除、椎管减压和(或)内固定重建。统计并发症发生类型,分析发生原因和防治方法。结果本研究共有16例出现并发症,其中围手术期并发症12例:肺炎合并胸腔积液3例,单侧支气管积脓合并肺不张3例,肺损伤2例,暂时性单侧肢体瘫痪1例,暂时性肋间神经痛2例,伤口表浅感染1例。远期并发症包括结核复发2例,其中1例多节段椎体结核合并广泛脓肿术后4周复发,1例糖尿病患者术后8个月复发。合并轻度后凸畸形和局部疼痛2例。结论胸腔镜辅助胸椎前路手术并发症发生的类型主要与手术适应证的选择、手术操作和麻醉技术密切相关,只有严格手术适应证、改善麻醉技术、遵循操作原则和完善围手术期处理,才能发挥胸腔镜的优势,减少并发症的发生。
Objective To analyze occurrence, prevention and treatment of the complications of thoracoscopic assisted spine surgery. Methods Retrospective review of 182 patients who underwent standard thoracoscopic technique or video-assisted thoracic surgical procedure from October 1998 to August 2004. The treatment of thoracic diseases included debridement, decompression with （or） reconstruction. The total number of complications were recorded, and its mechanism, prevention and treatment were analyzed. Results Complications occurred in 16 patients, 12 cases of perioperative complications included 3 patients suffered from pneumonia, 3 pulmonary atelectasis, 2 patients＇ lung injuried by trocar, 1 patient obtained transient monoplegia, 2 suffered from transient intercostal nerve pain and 1 had superficial incision infection. Long-term complications occurred in 4 cases： spinal tuberculosis relapsed 2 cases （one who had diabetes obstained relapse in 8 months of post-operation and another relapsed with complex spinal tuberculosis in 4 weeks postoperation）, 2 patients suffered from kyphosis deformity and pain. Conclusions The type and incidence of complications with thoracoscopic spine surgery mainly depend on indication, operation procedures and anesthesia, only by limit surgical indication, ameliorate technique, obey surgical priciple and consummated perioperative treatment can we obstain miniinvasive effect by thoracoscopic assisted spine surgery.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2006年第4期228-230,共3页
Chinese Journal of Surgery
关键词
胸腔镜
脊柱
外科手术
手术中并发症
手术后并发症
Thoracoscopes
complications
Postoperative complications Spine
Surgical procedures, operative
Intraoperative
