全麻与局麻经皮椎体后凸成形术的比较
General anesthesia versus local anesthesia for percutaneous kyphoplasty
张伟 1姜盟盟 1梁晓松 1任帅 1孙其志1
作者信息
- 1. 泰安八十八医院,山东泰安 271000
- 折叠
摘要
[目的]比较全麻与局麻下经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗胸腰椎骨质疏松性骨折早期结果.[方法]回顾性分析2022年9月-2023年10月本院收治的104例骨质疏松性椎体压缩骨折患者的临床资料.根据术前医患沟通结果,51例采用全麻PKP,53例采用局麻PKP.比较两组患者住院期间临床与影像资料.[结果]全麻组在手术时间[(42.2±2.7)min vs(53.6±4.1)min,P＜0.001]、透视次数[(25.7±6.3)次 vs(32.4±9.6)次,P＜0.001]、Kolcaba 舒适度评分[(83.4±8.6)vs(74.7±8.1),P＜0.001]均显著优于局麻组,但是前者恢复下地行走时间显著晚于后者[(29.5±5.5)h vs(26.6±3.4)h,P=0.002].两组间早期不良反应发生率的差异无统计学意义(P＞0.05).影像方面,与术前相比,两组患者术后椎体前缘高度(anteriorvertebral height,AVH)和局部后凸角(local kyphotic angle,LKA)均有显著改善(P＜0.05).出院时全麻组在 AVH[(23.5±1.3)mm vs(20.1± 1.1)mm,P＜0.001]和LKA[(7.2±1.7)°vs(9.3±1.8)°,P＜0.001]均显著优于局麻组.[结论]与局麻相比,全麻下PKP确实减少了手术时间和辐射暴露,同时还能更好地重建椎体.另外全麻组患者治疗过程的舒适度明显高于局麻组.
Abstract
[Objective]To compare the early results of general and local anesthesia for percutaneous kyphoplasty(PKP)in the treat-ment of thoracolumbar osteoporotic fractures.[Methods]A retrospective study was conducted on 104 patients who received PKP for thora-columbar osteoporotic fractures in our hospital from September 2022 to October 2023.According to preoperative doctor-patient communica-tion,51 patients had PKP performed under general anesthesia(GA),while other 53 patients were under local anesthesia(LA).The clinical and imaging data during hospitalization were compared between the two groups.[Results]The GA group proved significantly superior to the LA group in terms of operation time[(42.2±2.7 min)vs(53.6±4.1)min,P＜0.001],fluoroscopy times[(25.7±6.3)vs(32.4±9.6),P＜0.001]and Kolcaba comfort score[(83.4±8.6)vs(74.7±8.1),P＜0.001],whereas the former resumed walking significantly later than the latter[(29.5±5.5)hours vs(26.6±3.4)hours,P=0.002].There was no statistically significant difference in the incidence of early adverse reactions between the two groups(P＞0.05).Regarding imaging,the anterior vertebral height(AVH)and local kyphotic angle(LKA)were significantly improved postoperatively in both groups compared with those preoperatively(P＜0.05).At the discharge,the GA group was significantly su-perior to the LA group in terms of AVH[(23.5±1.3)mm vs(20.1±1.1)mm,P＜0.001]and LKA[(7.2±1.7)° vs(9.3±1.8)°,P＜0.001].[Conclu-sion]Compared with under local anesthesia,the PKP under general anesthesia does indeed reduce the operation time and radiation expo-sure,reconstruct the vertebral body better with considerably better comfort level.
关键词
骨质疏松/椎体压缩骨折/经皮后凸成形术/全麻/局麻Key words
osteoporosis/vertebral compression fracture/percutaneous kyphoplasty/general anesthesia/local anesthesia引用本文复制引用
出版年
2024
NETL
NSTL
万方数据