摘要
目的:探讨颈前路减压术(ACSS)后不放置引流管的临床疗效及安全性。方法:将2019年6月至2020年12月行双节段颈前路椎间盘切除植骨融合术(ACDF)后未放置引流管的20例患者作为未放置引流管组,采用1∶2匹配病例进行对照研究,按照性别相同、手术节段相同的条件选择40例放置引流管患者作为放置引流管组。比较两组患者术后各随访时间点临床疗效[日本骨科学会(JOA)评分、疼痛视觉模拟评分(VAS)]、并发症(颈部血肿、颈部肿胀、吞咽困难)、术后康复(术后卧床及术后住院时间)、患者满意度的差异。结果:本研究纳入60例行双节段ACDF患者,男36例,女24例;年龄32~79岁,平均(53.8±9.3)岁。未放置引流管组男12例,女8例,年龄32~63岁,平均(51.6±8.8)岁;放置引流管组男24例,女16例;年龄36~79岁,平均(54.9±9.4)岁。两组患者的年龄、性别、体重指数(BMI)、手术节段、手术时间差异均无统计学意义(P均>0.05)。两组术后各随访时间点的JOA评分及颈痛、臂痛VAS评分均较术前有显著改善(P均<0.01)。术前和术后各随访时间点,两组患者的JOA评分及颈痛、臂痛VAS评分比较差异均无统计学意义(P均>0.05)。两组患者术后均未出现颈部血肿。术后各随访时间点,两组患者的椎前软组织厚度及吞咽困难发生率比较差异均无统计学意义(P均>0.05)。与放置引流管组比较,未放置引流管组患者术后卧床时间及术后住院时间显著缩短,术后满意度显著升高(P均<0.01)。结论:ACSS术后不放置引流管安全、可行,不增加术后血肿及吞咽困难的风险,可显著缩短术后卧床及术后住院时间,有利于患者术后康复。
Objective:To explore the clinical efficacy and safety of anterior cervical spine surgery(ACSS)without drainage tube.Methods:Twenty patients who underwent double-level anterior cervical decompression and fusion(ACDF)surgery without drainage tube from June 2019 to December 2020 were selected as the observation group.Employing a 1∶2 matched case-control study design,40 patients with drainage tube were selected as the control group with gender and surgical segment matched.Clinical efficacy(Japanese Orthopedic Association[JOA],Visual Analog Scale[VAS]score),complications(cervical hematoma,neck swelling,dysphagia),postoperative recovery(time bedridden and postoperative hospital stay)and satisfaction were compared between the two groups at postoperative follow-up time points.Results:This study included 60 patients(24 males and 36 females)undergoing double-level ACDF,with ages ranging from 32 to 79 years and an average of(53.8±9.3)years.There were 12 males and 8 females in the group without drainage tube.The age ranged from 32 to 63 years,with an average of(51.6±8.8)years.In the drainage tube group,there were 24 males and 16 females.The age ranged from 36 to 79 years,with an average of(54.9±9.4)years.There were no significant differences in terms of age,gender,body mass index(BMI),surgical segments and surgical time between the two groups(all P>0.05).Both groups showed significant improvements in JOA scores,the neck pain and arm pain VAS scores at each postoperative follow-up time point compared to preoperative scores(all P<0.01).There were no significant differences in JOA scores,neck pain and arm pain VAS scores between the two groups at preoperative and postoperative follow-up time points(all P>0.05).Neither group experienced cervical hematoma postoperatively.There were no significant differences in anterior neck soft tissue thickness or the incidence of dysphagia between the two groups at each postoperative follow-up time(all P>0.05).Compared with the drainage tube group,patients in the no drainage tube group ex
作者
刘浩
洪瑛
孟阳
王型金
刘洋
王贝宇
丁琛
LIU Hao;HONG Ying;MENG Yang;WANG Xingjin;LIU Yang;WANG Beiyu;DING Chen(Departement of Orthopaedic,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Operating Room,West China Hospital,Sichuan University,Chengdu 610041,China;West China School of Nursing,Sichuan University,Chengdu 610041,China)
出处
《中华骨与关节外科杂志》
CSCD
北大核心
2024年第3期214-219,共6页
Chinese Journal of Bone and Joint Surgery
基金
四川省科技计划项目(2019YFQ0002)。
关键词
颈前路减压手术
血肿
吞咽困难
引流管
Anterior Cervical Spine Surgery
Hematoma
Dysphagia
Drainage Tube
