颈椎OPLL与非OPLL患者经前路手术的麻醉管理分析  

Analysis of anesthesia management for the cervical OPLL and non-OPLL patients undergoing anterior surgery

作　　者：王成才[1] 徐文韵[1] 陈德玉[1] 

机构地区：[1]上海长征医院,200003

出　　处：《中国医学创新》2009年第35期22-23,共2页Medical Innovation of China

摘　　要：目的通过对比颈椎后纵韧带骨化症(ossification of posteriorlongitudinal ligament,OPLL)与非OPLL颈椎病经前路减压融合手术平均每个节段手术时间、出血量和输血量上的差异,为完善麻醉方案提供参考依据。方法选择笔者所在医院最近两年的颈椎OPLL经前路减压融合手术患者30例和随机抽取30例非OPLL颈椎病(剔除肿瘤和外伤患者)经前路手术患者,分析它们平均在每个节段手术时间、出血量和输血量上的差异性。结果 OPLL比非O PLL颈椎病患者前路减压融合术平均在每个节段所花的手术时间明显要长(P<0.01)、出血量显著增加(P<0.01)。OPLL患者大部分需要输血,平均输血量约为850 ml,非OPLL患者基本不用输血。结论 OPLL经前路手术所需时间比非OPLL颈椎病前路手术时间要长,出血量明显增加,大部分患者需要输血。因此,OPLL患者手术麻醉方案中应包括有创动脉血压监测、尿量监测和深静脉穿刺置管,多节段OPLL者术前必需充足备血。Objective To provide reference for improving the anesthesia program by comparing cervical ossification of posterior longitudinal ligament with non - OPLL of cervical spandylopathy by anterior decompression and fusion surgery on average operation time in each segment of the flower , bleeding volume and transfusion of blood volume. Methods To select thirty patients suffering OPLL and thirty patients of non - OPLL cervical spondylopathy （ with randomly selected, excluding tumor and trauma patients） by anterior decompression and fusion surgery in the recent two years in Chang zheng Hospital, and to analyze average their operation time in each segment of the flower, bleeding volume and transfusion of blood volume on the differences. Results It was spent significantly longer operative time on average in each segment than non - OPLL patients with anterior cervical decompression and fusion surgery （ P 〈 0. 01 ）. The hemorrhage volume of OPLL increased significantly than non - OPLL patients on average in each segment （ P 〈0. 01 ）. Most of OPLL patients required blood transfusion, and the average volume of blood transfusion was 850 ml. Most didn＇s have a blood transfusion in patients with non - OPLL. Conclusion The operation time of OPLL patients was longer than non - OPLL patient＇s, hemorrhage volume was more than the non - OPLL patient＇s, and most patients needed blood transfusion. Therefore, anesthesia should be included invasive arterial blood pressure monitoring, urine monitoring and deep - vein catheterization, multi - segmental OPLL patients were adequate preoperative preparation of blood.

关 键 词：OPLL 非OPLL颈椎病 颈椎前路减压融合术 出血量 手术时间 

分 类 号：R614[医药卫生—麻醉学]