内螺纹环锯在骨组织疾病活检与治疗中的应用

The Application of Internal Thread Trephine in the Biopsy and Treatment of Bone Tissue Diseases

摘要:

【摘要】 目的：探讨内螺纹环锯在骨组织疾病活检中应用意义。方法：回顾性分析2021 年 1 月~2022 年 12 月期间在我院实施骨组织活检的疑似椎体病变患者32例，根据取样环锯类型分为两组：观察组（内螺纹环锯，16例）、对照组（普通环锯，16例）。所有穿刺均在局麻下进行。常规建立工作通道，缓慢旋入环锯，透视定位，通过病灶后取出环锯，取下标本。根据患者的临床就诊资料，统计对比两组患者手术相关指标、检测结果及术后不良反应发生情况。结果：两组患者的年龄、性别、病程以及身体质量指数（Body mass index，BMI）均无差异（P＞0.05）。所有患者均顺利完成手术，两组活检成功率均为100%。观察组、对照组术中出血量均少于 5ml，分别为1.0~5.0（2.5±0.7）mL、1.0~4.8（2.8±0.9）mL，无差异（P＞0.05）。观察组、对照组手术时间分别为9.0~24（17.1±2.5）min、11.0~29.0（19.7±3.1）min，观察组较短（P＜0.05）。观察组取样节段：颈椎6例、胸腰椎骶椎10例、骶髂关节7例；对照组：颈椎9例、胸腰椎骶椎10例、骶髂关节12例。两组取样节段、组织病理检查结果、穿刺组织阳性率（100% vs 93.8%）、穿刺结果阳性率（87.5% vs 93.8%）以及术后并发症总发生率（37.5% vs 68.8%）均无统计学差异（P＞0.05）。结论：负压下使用内螺纹环锯可明显缩短椎体活检时间，对穿刺活检阳性率、术后并发症发生率无显著影响。

Abstract:

Abstract: Objective To investigate the application significance of internal thread trephine in the biopsy of bone tissue disease. Methods A retrospective analysis was performed on 32 patients with suspected vertebral lesions who underwent bone tissue biopsy in our hospital from January 2021 to December 2022, and they were divided into two groups according to the type of sampling trephination: the observation group (internal thread trephine, 16 cases) and the control group (common trephine, 16 cases). All punctures were performed under local anesthesia. The working channel was routinely established, the trephine was slowly rotated in, fluoroscopic positioning was performed, the trephine was removed after passing through the lesion, and the specimen was removed. According to the clinical data of the patients, the operation-related indexes, test results and postoperative adverse reactions of the two groups were statistically compared. Results There were no differences in age, gender, course of disease and body mass index (BMI) between the two groups (P > 0.05). All patients successfully completed the operation, and the success rate of biopsy in both groups was 100%. The intraoperative blood loss in the observation group and the control group was less than 5ml, and was 1.0~5.0 (2.5±0.7) mL and 1.0~4.8 (2.8±0.9) mL, respectively, with no difference (P > 0.05). The operation time in the observation group and the control group was 9.0~24 (17.1±2.5) min and 11.0~29.0 (19.7±3.1) min, respectively, which was shorter in the observation group (P < 0.05). The sampling segments in the observation group: cervical spine 6 cases, thoracolumbar sacral spine 10 cases, sacroiliac joint 7 cases; The control group: cervical spine 9 cases, thoracolumbar sacral spine 10 cases, sacroiliac joint 12 cases. There were no statistically significant differences in sampling segments, histopathological results, positive rate of puncture tissue (100% vs 93.8%), positive rate of puncture results (87.5% vs 93.8%) and total incidence of postoperative complications (37.5% vs 68.8%) between the two groups (P > 0.05). Conclusions The use of internal thread trephine under negative pressure can significantly shorten the vertebral biopsy time, but has no significant effect on the positive rate of puncture biopsy and the incidence of postoperative complications. Key words: Bone tissue disease biopsy; Internal thread trephine; Common trephine; Operation time; Biopsy positive rate