临床骨科杂志2016，Vol.19Issue(2)：151-154,4.DOI:10.3969/j.issn.1008-0287.2016.02.007
手术体位对高龄患者腰椎后路手术的影响
The effect and clinical outcome of prone and lateral position on the posterior lumbar inter-body fusion surgery in elderly patients
黎裕明 1王华 2戴海 1庞俊峰 1刘会江 1黄宗贵1
作者信息
- 1. 南宁市第一人民医院骨科，广西 南宁 530001
- 2. 中山大学附属第一医院骨科，广东 广州 510080
- 折叠
摘要
Abstract
Objective To investigate the safety and clinical outcome of prone and lateral operation position for pa-tients older than 75 years with lumbar degenerative disc disease. Methods 65 patients with degenerative disease of lumbar spine who received posterior lumbar interbody fusion were enrolled,and randomly divided into prone group( n=30)and lateral positioning group(n=35). All patients underwent prone position or lateral position function training preoperatively. The medical record was reviewed to preoperative coexisting diseases, operative position tolerance, VAS and ODI in the pre-and post-operation, operative time, bleeding, partial pressure of CO2 ( PCO2 ) , wall-break-ing rate of pedicle screw placement, recovery time from anesthesia,excellent-good rate of one year postoperation, and so on. Results There were shorter operative time, less bleeding, lower PCO2 and shorter anesthesia recovery time in the lateral group(P<0. 01). There was no significant difference in the two group for wall-breaking rate of pedicle screw placement and excellent-good rate of clinical effect(P>0. 05). The pain VAS and ODI for body function im-proved significantly in the postoperation comparing with the preoperative in both groups(P<0. 01),but there wasn′t difference between two groups( P>0. 05 ) . All cases were followed up for one year. There was no significant differ-ence in the excellent-good rate of Macnab improved standard score between two groups ( P>0. 05 ) . Conclusions The lateral position can improve senile patients′ operative position tolerance, save operative time, reduce bleeding and postoperative PCO2 .关键词
腰椎退变性疾病/俯卧位/侧卧位/老年人Key words
lumbar spine degenerative disease/prone position/lateral position/aged分类
医药卫生引用本文复制引用
黎裕明,王华,戴海,庞俊峰,刘会江,黄宗贵..手术体位对高龄患者腰椎后路手术的影响[J].临床骨科杂志,2016,19(2):151-154,4.
