| 张 骏 陈 钢.血流动力学不稳定性固定急救技术在椎管狭窄伴退行性腰椎侧凸老年患者中的临床效果[J].中国现代医生,2021,59(5):82-86 |
| 血流动力学不稳定性固定急救技术在椎管狭窄伴退行性腰椎侧凸老年患者中的临床效果 |
| Clinical efficacy of hemodynamic instability fixed first aid technology in elderly patients with spinal stenosis and degenerative lumbar scoliosis |
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| DOI： |
| 中文关键词: 椎管狭窄 DLS 血流动力学不稳定性固定急救技术 老年人 |
| 英文关键词:Spinal stenosis DLS Fixed first aid technique for hemodynamic instability The elderly |
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| 中文摘要: |
| 目的 分析血流动力学不稳定性固定急救技术在椎管狭窄伴退行性腰椎侧凸老年患者中的临床效果，为临床治疗提供科学依据。方法 分析2016 年1 月至2017 年10 月于我院骨科就诊接受非融合动态稳定术治疗的56 例腰椎管狭窄老年患者的临床资料。结合患者围术期资料，比较术前，术后3、12、24 个月及末次随访时不同切面X 线检查参数、术后脊椎X 线片与MR 影像学表现、疼痛评分、日常生活能力评分、镇痛药物使用情况及并发症情况。结果 所有患者在减压性椎板切除术后，所有减压节段均接受Dynesys 系统非融合稳定术，平均住院时间为（6.18±1.85）d。术后3、12、24 个月及末次随访时冠状面平衡、矢状面平衡与术前比较，差异有统计学意义（P＜0.05）；患者治疗后X 线片与MR 检查评估结果良好，腰痛、腿痛VAS 评分较治疗前明显下降，手术前ODI 为（57.72±10.70）%，术后24 个月的ODI 指标（35.17±6.89）%，差异有统计学意义（P＜0.05）。术前使用镇痛药物者28 例（100.00%），术后减少至18 例（64.29%）；术后15 例（53.57%）减少镇痛药用量，3 例（10.71%）维持相同剂量。患者并发症发生概率较小，疗效突出。结论血流动力学不稳定性固定急救技术能有效改善椎管狭窄伴退行性腰椎侧凸老年患者症状，安全有效，效果突出，能有效改善患者的生活质量。 |
| 英文摘要: |
| Objective To analyze the clinical efficacy of hemodynamic instability fixed first aid technology in elderly patients with spinal stenosis and degenerative lumbar scoliosis,and to provide scientific basis for treatment.Methods The clinical data of 56 elderly patients with lumbar spinal stenosis admitted to our hospital treated with non-fusion dynamic stabilization from January 2016 to October 2017 were analyzed.Combined with the perioperative data of pa tients,the X-ray examination parameters of different sections before operation,3 months,12 months and 24 months after operation and the last follow-up,the spine X-ray film and MR imaging performance after operation,the pain score,activity of daily living score,use of analgesics and incidence of complications were compared.Results After decompressive laminectomy of all patients,all decompression segments were treated with Dynesys system non-fusion stabilization,and the average hospitalization time was(6.18±1.85) days.After 3 months,12 months and 24 months after operation and the last follow-up,the coronal plane balance,sagittal plane balance were significantly different from those before operation,with statistically significant differences (P＜0.05).After treatment,the evaluation results of X-ray film and MR examination were good,and the VAS score of low back pain and leg pain was significantly lower than that before treatment.The ODI before operation was(57.72±10.70)%,and the ODI after 24 months of operation was(35.17±6.89)%,with statistically significant differences(P＜0.05).28 cases (100.00%) used analgesics before operation,and 18 cases (64.29%)used analgesics after operation;15 cases(53.57%) reduced the dosage of analgesics after operation,and 3 cases (10.71%)maintained the same dosage.The incidence of complications was small,and the therapeutic efficacy was outstanding.Conclusion Hemodynamic instability fixation first aid technology can effectively improve the symptoms of elderly patients with spinal stenosis and degenerative lumbar scoliosis,which is safe and effective,and can obviously improve the quality of life of patients. |
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