[目的]在三维模型确定与镜下观测一致的骨性标志点,测量辅助单孔分体内镜准确定位并安全减压L_(4)出口神经根的参数。[方法]构建34例L_(4/5)单侧极外侧腰椎间盘突出症患者腰椎CT三维模型,以横突根部下缘与峡部外侧缘的交点(intersection of the lower margin of the transverse process root with the lateral margin of the isthmus,ITPI)为骨性标志点,分别在ITPI所在的矢状面测量相关指标,并进行男女间、健侧与患侧的比较。[结果]L_(4)出口神经根下缘投影于L_(4/5)椎间隙之上,健侧占比(4/34,11.8%)小于患侧占比(18/34,52.9%),投影于L_(4/5)椎间隙之内,健侧占比(30/34,88.2%)大于患侧占比(12/34,35.3%)。分别测量ITPI至L_(4)出口神经根上缘的垂直距离、L_(4)出口神经根下缘的垂直距离、L_(4)出口神经根后缘的前后水平距离、L_(4)下终板的垂直距离、L_(5)上终板的垂直距离、L_(4)椎弓根下缘的垂直距离;ITPI分别至L_(4)下终板最外侧缘的左右水平距离以及其所在矢状面上L_(4)出口神经根上缘的垂直距离、L_(4)出口神经根下缘的垂直距离、L_(4)下终板的垂直距离、L_(5)上终板的垂直距离;ITPI分别至L_(4)椎弓根内侧壁的左右水平距离、硬脊膜外侧缘的左右水平距离,以上指标男女间、健患侧之间差异均无统计学意义(P>0.05)。各测量指标与年龄、BMI均无显著相关性(P>0.05)。[结论]以L_(4)横突根部下缘与峡部外侧缘交点作为骨性标志点,无需向上探查,只需向外、向下磨除部分骨质即可显露并安全减压L_(4)出口神经根。
目的:研究剖宫产术后腹壁子宫内膜异位症(AWE)的临床特征,以了解其相关特点。方法:对滨州医学院附属医院在2018年1月至2024年5月期间收治的134例经组织病理证实为剖宫产术后腹壁子宫内膜异位症患者的临床资料进行回顾性分析。根据腹壁子宫内膜异位症病灶的侵袭深度及范围,将其分为皮下脂肪型、鞘膜型和腹膜型三种类型。按照内异症病灶数量分为单发型、多发型。比较腹壁子宫内膜异位症各个分型之间的临床特点及差异。结果:根据术中探查内异症病灶数分型,单发型122例(91%),多发型12例(9%)。与单发型相比,多发型AWE的手术时间长(P P P = 0.035),手术时间更长(P P P P P P Objective: To investigate the clinical characteristics of abdominal wall endometriosis (AWE) after cesarean section in order to understand its related characteristics. Methods: The clinical data of 134 patients with abdominal wall endometriosis confirmed by histopathology admitted to the Affiliated Hospital of Binzhou Medical University from January 2018 to May 2024 were retrospectively analyzed. According to the invasion depth and scope of abdominal endometriosis, the lesions were classified into subcutaneous lipomatosis, vaginalis, and peritoneum. Based on the number of endometriosis lesions, it can be divided into single types and multiple types. To compare the clinical features and differences among different types of abdominal endometriosis. Results: According to the number of intraoperative investigations, there were 122 cases (91%) of single type and 12 cases (9%) of multiple type. Compared with single-style AWE, multi-style AWE had longer operation time (P P P = 0.035), longer operation time (P P P P P P < 0.01).
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