局麻下经皮椎体强化术中短暂性截瘫13例临床特点  

Clinical characteristics of 13 patients with transient paraplegia during percutaneous vertebral augmentation under local anesthesia

作　　者：侍管 陈浩[1] 贾璞[1] 包利[1] 陈萌萌[1] 唐海[1] 冯飞[1] SHI Guan;CHEN Hao;JIA Pu;BAO Li;CHENG Meng-meng;TANG Hai;FENG Fei(Department of Orthopedics,Beijing Friendship Hospital,Capital Medical University,Beijing,100050,China)

机构地区：[1]首都医科大学附属北京友谊医院骨科,北京100050

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2023年第2期102-106,共5页Chinese Journal Of Osteoporosis And Bone Mineral Research

摘　　要：目的 分析13例接受局麻下经皮椎体强化术(percutaneous vertebral augmentation, PVA)的患者发生短暂性截瘫的临床特点。方法 对北京友谊医院13例PVA短暂性截瘫患者进行分析,收集包括手术、椎体节段、麻醉剂量、手术时间、截瘫恢复时间和随访在内的临床数据。结果 13例患者中男5例、女8例;年龄62~83岁、平均73.3岁。每个椎体注射的平均麻醉剂量为5.84 mL,患者平均需要217.3 min才能完全恢复感觉和运动,麻醉剂量与完全恢复所需时间无关。患者术前疼痛视觉模拟评分(Visual Analog Scale, VAS)7.462±0.183(n=13)、术后1个月1.615±0.213(n=13)、术后3个月1.538±0.447(n=13)、术后6个月1.273±0.273(n=11),术后均较术前明显改善(P<0.000 1)。术前Oswestry功能障碍指数(Oswestry Disability Index, ODI)(69.540±1.323)%(n=13)、术后1个月(12.310±1.517)%(n=13)、术后3个月(12.460±2.980)%(n=13)、术后6个月(7.000±0.884)%(n=11),术后均较术前有明显改善(P<0.000 1)。结论 局麻下经皮椎体强化术中短暂性截瘫的临床特点与蛛网膜下腔麻醉恢复期相似。Objective To analyze clinical characteristics of transient paraplegia in 13 patients receiving percutaneous vertebral augmentation(PVA)under local anesthesia.Methods The data of 13 patients with transient paraplegia,including operation,vertebral body segment,anesthesia dose,operation time,paraplegia recovery time and follow-up,were collected from Beijing Friendship Hospital.Results Thirteen patients aged between 62 and 83 years with a mean age of 73.3 years,including 8 females and 5 males,were included in the study.The average anesthesia dosage injected into each vertebral body was 5.84 mL.The patients took an average of 217.3 minutes to fully recover sensation and movement,which was independent of the anesthesia dosage.The preoperative Visual Analog Scale(VAS)was 7.462±0.183(n=13),while the postoperative VAS at 1,3 months,and 6 months were 1.615±0.213(n=13),1.538±0.447(n=13),and 1.273±0.273(n=11),respectively.All postoperative VAS scores were significantly improved compared to the preoperative score(P<0.0001).The preoperative Oswestry Disability Index(ODwI)as(69.540±1.323)%(n=13),while the postoperative ODI at 1,3,and 6 months were(12.310±1.517)%(h=13),(12.460±2.980)%(n=13),and(7.000±0.884)%(n=11),respectively.All postoperative ODI scores were significantly improved compared to the preoperative score(P<0.0001).Conclusion TThe clinical characteristics of 13 cases of transient paraplegia during percutaneous vertebral augmentation under local anesthesia is similar to recovery period of subarachnoid anesthesia.

关 键 词：经皮椎体强化术 局部麻醉 短暂性截瘫 

分 类 号：R614.3[医药卫生—麻醉学]