局部麻醉下揭盖术治疗胸椎黄韧带骨化症的效果及安全性  

Efficacy and safety of “cap uncovering technique” under local anesthesia in the treatment of ossification of the ligamentum flavum of the thoracic vertebrae

作　　者：卢守亮 程才[1] 赵晔[1] 李书奎[1] 郭志远 孙鹤 刘东明[1] 蒲晓[1] LU Shou-liang;CHENG Cai;ZHA;LI Shu-kui;GUO Zhi-yuan;SUN He;LIU Dong-ming;PU Xiao(Departent of Orthopedics,Central Hospital of Cangzhou City in Hebei Province,Cangzhou 061000,China)

机构地区：[1]河北省沧州市中心医院骨科,河北沧州061000

出　　处：《中国当代医药》2018年第32期4-7,15,共5页China Modern Medicine

基　　金：河北省沧州市科学技术研究与发展指导计划项目(1123038ZD)

摘　　要：目的探讨局部麻醉下揭盖术治疗胸椎黄韧带骨化症的效果及安全性。方法选取2013年1月~2016年12月我院骨科收治的76例胸椎黄韧带骨化症患者,根据麻醉方式的不同分为局麻组(36例)和全麻组(40例)。局麻组在局部麻醉下行手术治疗,全麻组在全身麻醉下行手术治疗。全部患者均行胸椎后路揭盖术,比较两组患者的神经功能恢复率、神经系统并发症发生率、术程时间、出血量、麻醉并发症发生率。结果两组患者术后的神经功能恢复率比较,差异无统计学意义(P>0.05)。局麻组患者术后的神经系统并发症发生率低于全麻组,术程时间短于全麻组,出血量少于全麻组,麻醉并发症发生率低于全麻组,差异均有统计学意义(P<0.05)。结论局部麻醉下行胸椎后路揭盖术,麻醉效果可以满足手术要求,同时便于观察术中神经功能变化,能够降低脊髓损伤的风险,避免全身麻醉带来的麻醉并发症。Objective To investigate the therapeutic efficacy and safety of ＂cap uncovering technique＂ under local anesthesia in the treatment of ossification of the ligamentum flavum of the thoracic vertebrae. Methods From January2013 to December 2016, 76 cases of ossification of ligamentum flavum in orthopedics department of our hospital were enrolled. According to the method of operation, they were divided into the local anesthesia group（36 cases） and the general anesthesia group（40 cases）. The local anesthesia group was operated under local anesthesia, and the general anesthesia group was operated under general anesthesia. All patients underwent thoracic posterior ＂cap uncovering technique＂. The recovery rate of neurological function, the incidence rate of complications of the nervous system, time of the operation, hemorrhage amount, the incidence rate of anesthetic complications were compared between the two groups. Results There was no significant difference in the recovery rate of neurological function between the two groups after surgery（P〉0.05）. The incidence rate of complications of the nervous system in the local anesthesia group was lower than that in the general anesthesia group, and the duration of operation in the local anesthesia group was shorter than that in the general anesthesia group, the amount of bleeding of the local anesthesia group was less than that of the general anesthesia group, and the incidence of anesthesia complication of the local anesthesia group was lower than that of general anesthesia group, with significant difference（P〈0.05）. Conclusion Thoracic posterior ＂cap uncovering technique＂under local anesthesia can satisfy the requirements of surgery, and it is convenient to observe the changes of nerve function, reduce the risk of spinal cord injury, and avoid the anesthetic complications caused by general anesthesia.

关 键 词：局部浸润麻醉 胸椎黄韧带骨化症 椎板切除术 并发症 

分 类 号：R681.5[医药卫生—骨科学]