疼痛治疗中硬膜外穿刺针的选择

目的介绍一种创伤小、操作简便、感觉明显、符合微创原则的硬膜外穿刺针及穿刺技术。方法选择235例用7G麻醉针行硬膜外间隙穿刺,共1000例次,列为7G组;186例用8G麻醉针行硬膜外穿刺共1000次,列为8G组。358例用16G Tuohy针行硬膜外穿刺列为T针组共1000例次,并比较3组穿刺后的并发症。结果三组患者穿刺后腰背痛发生率分别为0.3%、0.5%、45.2%,穿破硬脊膜发生率分别为0.6%、0.4%、0.3%,神经根损伤发生率分别为0.4%、0.3%、0.4%,穿刺后并发症的阳性率分别为4.3%、4.4%、46.2%,经统计学处理7G组同8G组比较无统计学差异（P〉0.05）,8G组同Tuohy针组比较差异有统计学意义（P〈0.05）。结论7G针和8G针穿刺均有创伤小,操作简便的优点,但是7G针针体易弯曲,针孔小易被堵塞。8G针则无此缺点且落空感更明显。可在疼痛治疗中推广应用。

Selection of neddle for epidural puncture in pain treatment

Objective To test different needles for epidural puncture with low injury and simple operating. Methods 779 patients were divided randomly into three groups. 235 patients were puncctured with 7G needle （group A）, 186 patients with 8G needle （group B）, 358 patients with 16 Tuohy needle （group C）. The complications of the three groups after puncture were compared . Result Postpunctural lumbago rates of the three groups were 0.3%, 0.5 %, 45.2%, tresis rates of spinal dura mater were 0.6%, 0.4%, 0.3%, nerve root injury rates were 4%, 3%, 4% respectively. Conclusion 8% puncture needle used in pain treatment has the advantages of few tissue injury and few side effects.