日间模式下开展椎间孔镜手术的早期疗效观察及延迟出院和再次入院情况分析  

Early efficacy observation and analysis of delayed discharge and readmission for carrying out foraminoscopic surgery under diurnal mode

作　　者：张杰 王功臣 张鸽 ZHANG Jie;WANG Gong-chen;ZHANG Ge(Department of Spine and Joint,Nanshi Hospital of Nanyang,Nanyang,Henan 473001,China)

机构地区：[1]南阳南石医院脊柱关节科,河南南阳473001

出　　处：《颈腰痛杂志》2023年第1期70-73,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨日间模式下开展椎间孔镜手术治疗腰椎间盘突出症(lumbar disc herniation,LDH)的早期疗效,并分析患者术后延迟出院及再入院情况。方法收集2018年1月~2020年10月行经皮椎间孔镜下椎间盘切除术(percutaneous transforaminal endoscopic discectomy,PTED)的271例患者资料,依据手术模式分组:常规住院模式下开展PTED手术118例,列入住院组;日间模式下开展PTED手术153例,列入日间组。对两组患者的围术期指标、疗效、延迟出院及再入院情况等数据进行比较。结果住院组患者的住院时间、医疗费用等指标数据均显著高于日间组(P<0.05);住院组术后并发症发生率为5.1%,日间组为5.2%,差异无统计学意义(P>0.05)。住院组患者术后延迟出院6例(5.1%),日间组15例(9.8%)。两组患者术后即刻和术后1年的疗效及优良率差异无统计学意义(P>0.05)。术后随访1年,住院组患者再入院7例(5.9%),日间组为10例(6.5%),再入院原因均为术后疼痛及LDH复发,组间差异无统计学意义(P>0.05)。结论日间模式下PTED手术的疗效和安全性与住院模式一致,且并未增加术后再入院率。手术并发症、患者心理因素等均是PTED日间手术患者延迟出院的主要原因。Objective To investigate the early efficacy of intervertebral foraminal endoscopic surgery in the treatment of lumbar disc herniation(LDH)in daytime mode,and to analyze the delayed discharge and readmission of patients after operation.Methods The clinical data of 271 patients who underwent percutaneous transforaminal endoscopic discectomy(PTED)from January 2018 to October 2020 were collected.According to the operation mode,the patients were divided into two groups:118 patients underwent PTED surgery under the conventional inpatient mode were included in the inpatient group;153 cases received PTED operation under daytime mode were included in daytime group.The perioperative indicators,curative effect,delayed discharge and readmission of the two groups were compared.Results The hospitalization time,medical expenses and other indicators of inpatients in the inpatient group were significantly higher than those in the daytime group(P<0.05).The incidence rate of postoperative complications in the inpatient group was 5.1%,and that in the daytime group was 5.2%,with no significant difference(P>0.05).There were 6 cases(5.1%)in the inpatient group and 15 cases(9.8%)in the daytime group with delayed discharge.There were no significant differences in the curative effect and excellent and good rate between the two groups immediately after operation and at 1 year after operation(P>0.05).After 1 year of follow-up,7 cases(5.9%)in the inpatient group and 10 cases(6.5%)in the daytime group were readmitted.The reasons for readmission were postoperative pain and LDH recurrence.There was no significant difference between the two groups(P>0.05).Conclusion The efficacy and safety of PTED surgery in daytime mode are consistent with that in hospitalization mode,and does not increase the postoperative readmission rate.Surgical complications and patients’psychological factors are the main reasons for the delayed discharge of PTED patients during daytime surgery.

关 键 词：腰椎间盘突出症 椎间孔镜 日间手术 延迟出院 术后再入院 

分 类 号：R681.53[医药卫生—骨科学] R687.3[医药卫生—外科学]