多模式神经电生理监测经皮内镜颈椎间盘切除术的早期疗效  

Analysis of early curative effect of multi-mode neuroelectrophysiological assisted percutaneous endoscopic cervical discectomy

作　　者：姚莉 余利鹏 朱莉莉[2] 周小花[2] 周燕 YAO Li;YU Lipeng;ZHU Lili;ZHOU Xiaohua;ZHOU Yan(Bone Spine Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China;Department of Anesthesiology and Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China)

机构地区：[1]南京医科大学第一附属医院骨脊柱外科,江苏南京210029 [2]南京医科大学第一附属医院麻醉手术科,江苏南京210029

出　　处：《西部医学》2021年第12期1813-1816,1825,共5页Medical Journal of West China

基　　金：江苏省自然科学基金面上项目(H0609)。

摘　　要：目的采用多模式神经电生理监测(NM)经皮内镜颈椎间盘切除术(PECD)及其对神经根型颈椎病患者的早期疗效。方法选取2019年6月~2020年6月我院收治的神经根型颈椎病患者92例,根据患者是否接受NM监测将其分为监测组(n=46)与非监测组(n=46)。给予监测组患者多模式神经电生理监测PECD治疗,给予非监测组患者单纯PECD治疗。对两组围术期相关指标、手术前后颈部与上肢VAS评分、患者神经功能恢复情况及术后并发症发生情况等进行比较。结果两组手术时间及术中出血量比较差异无统计学意义(P>0.05),监测组患者住院时间较非监测组显著缩短(P<0.05);两组术后1个月及末次随访时其颈部VAS评分及上肢疼痛VAS评分均较术前明显降低(P<0.05),两组间VAS评分比较差异无统计学意义(P>0.05);两组术后1个月及末次随访时JOA评分均较术前明显提高(P<0.05),两组间JOA评分比较差异无统计学意义(P>0.05);监测组患者术后并发症总发生率明显低于非监测组(P<0.05)。结论对实施PECD的患者给予NM监测治疗有助于患者早期康复,使术后并发症发生率降低,疗效安全可靠。Objective Multi-modal electrophysiological monitoring(Neurophysiological monitoring,NM)percutaneous endoscopic cervical discectomy(Percutanous endoscopic cervical discectomy,PECD)was used to analyze its early curative effect.Methods A total of 92 patients with radiculopathy of cervical spondylosis admitted to the Hospital from June 2019 to June 2020 were selected.They were divided into monitoring group(n=46)and non-monitoring group(n=46)according to whether they received NM assistance.The control group was given pure PECD treatment,and the observers were given multimodal neuroelectrophysiological assisted PECD treatment.The two groups of perioperative related indicators,neck and upper limb VAS scores before and after the operation,the patient's nerve function recovery and postoperative complications were observed and compared.Results In terms of perioperative indicators,there was no significant difference in operation time and intraoperative blood loss between the monitoring group and non-monitoring group(P>0.05),but the hospital stay was significantly shorter than that of the control group(P<0.05).In terms of postoperative VAS scores,the neck VAS scores and upper limb pain VAS scores of the two groups at 1 month after surgery and at the last follow-up were significantly lower than those before surgery,and the difference was significant(P<0.05).There was no significant difference between the two groups(P>0.05).In terms of neurological recovery,the JOA scores of the two groups at 1 month after surgery and at the last follow-up were significantly higher than those before surgery,and the difference was significant(P<0.05).There was no significant difference between the two groups(P>0.05).In terms of postoperative complications,the total incidence of patients in the monitoring group was 4.35%and the total incidence of 21.74%in the non-monitoring group was significantly reduced(P<0.05).Conclusion NM monitoring therapy for PECD patients can help patients recover early,reduce the incidence of postoperative complications

关 键 词：多模式神经电生理监测 经皮内镜颈椎间盘切除术 颈椎病 

分 类 号：R681.53[医药卫生—骨科学]