单侧双通道脊柱内镜腰椎间盘融合术患者加速康复外科分析  

Enhanced recovery after surgery in patients after unilateral biportal endoscopy lumbar interbody fusion

作　　者：郭敏 张钦[1] 胡锦生 张银顺[2] 葛鹏[2] 费广梅 GUO Min;ZHANG Qin;HU Jin-sheng;ZHANG Yin-shun;GE Peng;FEI Guang-mei(Operating Room,The Firs Affiliated Hospital of Anhui Medical University,Hefei,Anhui,230000,China)

机构地区：[1]安徽医科大学第一附属医院手术室,合肥230000 [2]安徽医科大学第一附属医院脊柱外科,合肥230000

出　　处：《中国骨与关节杂志》2024年第4期299-303,共5页Chinese Journal of Bone and Joint

摘　　要：目的分析加速康复外科(enhanced recovery after surgery,ERAS)方案在单侧双通道脊柱内镜腰椎间盘融合术(UBE lumbar interbody fusion,ULIF)患者中的有效性。方法选取2022年5月至2023年5月我院收治的142例腰椎间盘融合术患者,根据随机数字表法分为观察组(n=71)及对照组(n=71)。对照组采用常规方案,观察组采用ERAS方案。评估两组患者围术期指标、术后并发症、疼痛和腰背部功能。结果观察组术中失血量、术后第1~3天引流量、拔除引流管时间、离床和住院时间均低于对照组(P<0.05);术后7天,观察组腿部疼痛视觉模拟评分(visual analogue scale,VAS)、背部VAS评分和Oswestry功能障碍指数(Oswestry disability index,ODI)均低于对照组(P<0.05)。末次随访,两组患者术后椎间融合等级和优良率比较差异均无统计学意义(P>0.05)。结论ERAS方案能有效优化ULIF患者围术期指标,降低术后并发症发生率,减轻术后早期疼痛和改善功能。Objective To analyze the effectiveness of enhanced recovery after surgery(ERAS)in patients after unilateral biportal endoscopy lumbar interbody fusion(ULIF).Methods One hundred and forty lumbar disc fusion patients admitted between May 2022 and May 2023 were selected,and the patients were divided into the observation group(n=71)and control group(n=71)according to the random number table method.Routine protocol was used in the control group and ERAS protocol was used in the observation group.Perioperative indicators,postoperative complications,pain and low back function were assessed in both groups.Results The intraoperative and postoperative blood loss,postoperative drainage volume from day 1 to 3,drainage tube removal time,bed leaving and hospital stay of the observation group were lower than those of the control group(P<0.05);at 7 days postoperatively,the visual analogue scale(VAS)for leg pain,the VAS score for the back and the Oswestry disability index(ODI)of the observation group were all lower than those of the control group(P<0.05).At the final follow-up,there was no statistically significant difference in the postoperative intervertebral fusion grade and excellent rate between the two groups(P>0.05).Conclusions The ERAS protocol is effective in optimising perioperative indicators and functions,while reducing early postoperative pain and complication rate for patients with ULIF.

关 键 词：术后加速康复 脊柱融合术 腰椎 最小侵入性外科手术 

分 类 号：R687.3[医药卫生—骨科学]