围术期临床干预对后入路手术治疗胸腰椎结核患者应激反应的影响分析  

The impact analysis of stress response in posterior approach surgery in the treatment of thoracic and lumbar tuberculosis for clinical intervention in perioperative period

作　　者：曹兴[1] 杨渝勇[1] 邓淼[1] 曹国永[1] 

机构地区：[1]武警重庆市总队医院骨科,重庆400061

出　　处：《中国医学前沿杂志（电子版）》2015年第11期77-80,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨围术期临床干预对后入路手术治疗胸腰椎结核患者应激反应的影响。方法选择2012年1月至2014年6月本院接诊的120例胸腰椎结核患者为研究对象。按照随机数表法将入选患者分为观察组与对照组,每组各60例。对照组患者给予常规后入路治疗,观察组患者在对照组基础上行围术期临床干预。比较两组患者应激激素水平、生理状况、心理状况、疼痛情况及术后并发症发生率。结果观察组患者术中去甲肾上腺素、肾上腺素、皮质醇、内皮素水平以及心率、收缩压、舒张压均低于对照组(P<0.05);观察组患者手术当天抑郁及焦虑评分低于对照组(P<0.05);观察组患者术后总疼痛率及并发症总发生率均低于对照组(P<0.05)。结论围术期临床干预能够降低后入路手术治疗的胸腰椎结核患者的应激反应,减少术后并发症,值得临床推广。Objective To explore the impact analysis of stress response in posterior approach surgery in the treatment of thoracic and lumbar tuberculosis for clinical intervention in perioperative period. Method120 patients with thoracic spinal tuberculosis from January 2012 to June 2014 in our hospital were researched. According to a random number table method they were divided into control group and observation group, 60 cases in each group. Control group patients were treated with conventional posterior approach. On the basis of control group, observation group patients were given perioperative clinical intervention. The levels of stress hormones, physiological status, psychological status, pain and postoperative complications were compared between the two groups. Result During the operation, the levels of norepinephrine, epinephrine, cortisol, endothelin, heart rate, systolic blood pressure and diastolic blood pressure in observation group were lower than control group（P〈0.05）; on the day of surgery, the depression and anxiety score in observation group were lower than control group（P〈0.05）; total pain rate and complication rate in observation group were significant lower than control group（P〈0.05）. Conclusion Perioperative clinical intervention can reduce the stress response of posterior approach for the treatment of thoracic and lumbar tuberculosis, reduce postoperative complications, it is worthy of promotion in clinic.

关 键 词：围术期 胸腰椎结核 应激反应 

分 类 号：R687.3[医药卫生—骨科学]