CAJ | 학술논문

目的通过分析综合性医院骨科住院患者神经内科术前评估会诊的临床资料,探讨神经内科术前评估会诊骨科患者的意义.方法统计2011年5月1日至2012年4月30日神经内科术前评估会诊的骨科住院患者的临床资料.对申请会诊的骨科住院患者的一般情况、疾病诊断以及术前评估会诊内容、预后等进行统计分析.结果术前评估会诊患者共164例,男78例,女86例,年龄24～89(60.2±12.3)岁.脊柱骨科(37.8％,62/164)、创伤骨科(31.1％,51/164)及矫形骨科(23.2％,38/164)申请会诊数量最多.术前评估会诊种类:脑梗死101例(61.6％,101/164)最常见,其次为脑出血后遗症15例(9.1％,15/164)及帕金森病14例(8.5％,14/164)等.神经内科术前评估会诊意见包括:(1)指导患者围手术期用药,包括脑血管病、帕金森病、癫痫及其他神经系统疾病.(2)评估骨科术后脑梗死的风险,评价脑血管狭窄程度及侧支循环.(3)会诊需要检查的内容以经颅多普勒[52.4％(86/164)]、颈部血管超声[44.5％(73/164)]及头颅CT[37.8％(62/164)]最常见.(4)共取消手术8例.经术前会诊的患者仅有3例(2例老年痴呆患者,l例帕金森病患者)术后出现神经系统并发症.结论神经内科术前评估会诊骨科患者有利于降低其脑卒中风险,改善患者临床预后,避免出现神经系统并发症.
목적 통과분석종합성의원골과주원환자신경내과술전평고회진적림상자료,탐토신경내과술전평고회진골과환자적의의.방법 통계2011년5월1일지2012년4월30일신경내과술전평고회진적골과주원환자적림상자료.대신청회진적골과주원환자적일반정황、질병진단이급술전평고회진내용、예후등진행통계분석.결과 술전평고회진환자공164례,남78례,녀86례,년령24～89(60.2±12.3)세.척주골과(37.8％,62/164)、창상골과(31.1％,51/164)급교형골과(23.2％,38/164)신청회진수량최다.술전평고회진충류:뇌경사101례(61.6％,101/164)최상견,기차위뇌출혈후유증15례(9.1％,15/164)급파금삼병14례(8.5％,14/164)등.신경내과술전평고회진의견포괄:(1)지도환자위수술기용약,포괄뇌혈관병、파금삼병、전간급기타신경계통질병.(2)평고골과술후뇌경사적풍험,평개뇌혈관협착정도급측지순배.(3)회진수요검사적내용이경로다보륵[52.4％(86/164)]、경부혈관초성[44.5％(73/164)]급두로CT[37.8％(62/164)]최상견.(4)공취소수술8례.경술전회진적환자부유3례(2례노년치태환자,l례파금삼병환자)술후출현신경계통병발증.결론 신경내과술전평고회진골과환자유리우강저기뇌졸중풍험,개선환자림상예후,피면출현신경계통병발증.
Objective To investigate the evaluation of preoperative neurology consultation in orthopedics inpatients through analysis of the clinical data in general hospital.Methods Preoperative neurology consultation for orthopedics inpatients including general condition,diagnosis,preoperative assessment consultation content and prognosis from May 1,2011 to April 30,2012 were analyzed retrospectively.Results A total of 164 patients were enrolled,with 86 female and 78 male,the age was 24-89 (60.2 ± 12.3) years.The main consultation departments were spinal department (37.8％,62/164),trauma department (31.1％,51/164) and orthopedic department (23.2％,38/164).The main preoperative diseases were cerebral ischemia (61.6％,101/164),old intracranial hemorrhage (9.1％,15/164) and Parkinson disease(8.5％,14/164).The neurology preoperative consultations including:(1)Directing the drug administration in the perioperative period,including vascular disease,Parkinson disease,epilepsy and other neurological disease.(2)Evaluating the cerebral ischemia risk of the orthopedics operation,cerebral vascular stenosis and collateral circulation.(3) The main complementary tests were transcranial doppler [52.4％ (86/164)],extracranial sonography [44.5％(73/164)] and computer tomography [37.8％(62/164)].(4)Altogether 8 operations had been cancelled.Three patients (2 cases of Alzheimer disease,1 case of Parkinson disease) experienced postoperative neurologic complications.Conclusion Neurology preoperative evaluation consultation in orthopedic patients is helpful to reduce their risk of stroke,improve the prognosis of patients,and avoid neurological complications.