加速康复外科理念在椎体后凸成形术围术期的应用效果分析  

Perioperative application of enhanced recovery after surgery in kyphoplasty

作　　者：干旻峰[1] 程敏[1] 陆英杰[1] 周峰[1] 高艳[1] GAN Minfeng;CHENG Min;LU Yingjie;ZHOU Feng;GAO Yan(Department of Orthopaedics,the First Affiliated Hospital of Soochow University,Suzhou 215008,China)

机构地区：[1]苏州大学附属第一医院骨科,江苏苏州215008

出　　处：《东南大学学报（医学版）》2020年第6期704-708,共5页Journal of Southeast University(Medical Science Edition)

基　　金：国家高技术研究发展计划(863计划)项目(2015AA043201);国家自然科学基金重大研究计划项目(91849114)。

摘　　要：目的:评估加速康复外科(ERAS)理念在椎体后凸成形术(KP)围术期的应用效果。方法:回顾性分析2019年9月至2020年2月我科收治的91例骨质疏松性胸腰椎骨折患者的资料,根据是否采用ERAS理念进行围术期管理分成ERAS组(43例)和常规治疗组(48例)。分析两组术前住院天数、住院天数、疼痛、患者满意度以及术后恶心呕吐、谵妄、术后尿潴留、深静脉血栓形成等并发症发生情况。结果:两组术后第1天视觉模拟评分法(VAS)评分及Oswestry功能障碍指数(ODI)较术前明显改善(P<0.001),组间无明显差异,且末次随访时能很好维持。与常规治疗组相比,ERAS组术前住院天数更短,患者满意度较高,并且术后并发症发生率明显较低。结论:KP治疗骨质疏松性胸腰椎骨折有良好的疗效;采用ERAS理念可缩短术前准备时间,减少并发症发生,提高患者满意度。Objective:To investigate the efficacy of the enhanced recovery after surgery(ERAS)in the perioperative period of kyphoplasty(KP).Methods:91 cases of osteoporotic thoracolumbar fractures in our department from September 2019 to February 2020 were analyzed for this study.Patients were divided into the ERAS group(43 patients)and the conventional treatment group(48 patients)according to whether the practices of ERAS was used for perioperative management.The preoperative hospital stay,the duration of the hospital stay,the visual analogue scale(VAS),the Oswestry disability index(ODI),patient satisfaction,complications including postoperative nausea and vomiting,delirium,postoperative urinary retention and deep venous thrombosis were compared between the two groups.Results:The VAS and ODI scores of the two groups significantly improved on the first day after operation and remained high at the last follow-up(P<0.001),with no significant difference between the two groups.Compared with the conventional treatment group,the ERAS group had shorter preoperative hospital stay,higher patient satisfaction and lower incidence of postoperative complications.Conclusion:KP is effective in the treatment of osteoporotic thoracolumbar fractures,and ERAS could improve patient satisfaction and reduce complications.

关 键 词：加速康复外科 椎体后凸成形术 骨质疏松 胸腰椎骨折 围术期 并发症 

分 类 号：R619[医药卫生—外科学]