CAJ | 학술논문

目的：探讨儿童经口手术的围手术期处理方法，降低术后并发症发生率。方法对2007年3月至2012年12月广州军区广州总医院骨科医院手术治疗的18例儿童上颈椎疾患进行围手术期处理，观察患儿术后脊髓功能恢复和压迫改善情况，以及咽喉部切口愈合情况。结果日本骨科学会（JOA）评分由术前的（9.1±1.5）分改善为术后的（14.5±2.1）分，脑干延髓角（CMA）由术前的（135±14）°改善为术后的（156±10）°，差异均有统计学意义（P＜0.05）。无一例出现伤口感染，切口于8～10 d内愈合。结论采取周密的术前检查和评估，实施严格的围术期口腔护理，加强术后气道管理和早期营养支持，可有效降低儿童经口手术术后并发症的发生风险，保障手术安全实施，提高手术治疗效果。
목적：탐토인동경구수술적위수술기처리방법，강저술후병발증발생솔。방법대2007년3월지2012년12월엄주군구엄주총의원골과의원수술치료적18례인동상경추질환진행위수술기처리，관찰환인술후척수공능회복화압박개선정황，이급인후부절구유합정황。결과일본골과학회（JOA）평분유술전적（9.1±1.5）분개선위술후적（14.5±2.1）분，뇌간연수각（CMA）유술전적（135±14）°개선위술후적（156±10）°，차이균유통계학의의（P＜0.05）。무일례출현상구감염，절구우8～10 d내유합。결론채취주밀적술전검사화평고，실시엄격적위술기구강호리，가강술후기도관리화조기영양지지，가유효강저인동경구수술술후병발증적발생풍험，보장수술안전실시，제고수술치료효과。
Objective To explore perioperative management for transoral surgery in children, and to reduce the incidence of postoperative complications. Methods From March 2007 to December 2012, 18 children with upper cervical diseases underwent transoral surgery and were received perioperative management in Guangzhou General Hospital of Guangzhou Military Command. Postoperative spinal cord functional restoration, decompression and pharyngolaryngeal wound healing were observed. Results Japanese Orthopaedic Association (JOA) scores and cervicomedullary angle (CMA) were improved from preoperative (9.1 ± 1.5), (135 ± 14)° to postoperative (14.5 ± 2.1) and (156 ± 10)° respectively, the differences had statistical significance (P <0.05). No incision infection had happened, and wound healing was obtained in 8-10 d in all children. Conclusion Perioperative management including thorough preoperative examinations and evaluations, strict perioperative mouth care, intensive postoperative airway management and early nutrition support, could reduce incidence of postoperative complications effectively for pediatric transoral surgery, ensure safty of surgery and improve clinical effects.