武警医学
武警醫學
무경의학
Medical Journal of the Chinese People's Armed Police Forces
2015年
9期
888-891
,共4页
老年%腰椎管狭窄症%手术%并发症
老年%腰椎管狹窄癥%手術%併髮癥
노년%요추관협착증%수술%병발증
senile people%lumbar spinal canal stenosis%operation%complication
目的：探讨老年重度腰椎管狭窄症围术期特点和术后早期并发症的处理方法。方法回顾性分析我院骨科2008－02至2013－12共184例老年重度腰椎管狭窄症的病历资料，总结术前合并症、术中出血量、手术时间、住院时间，观察术后早期并发症的出现情况，总结处理方法。结果患者平均（68．77±5．76）岁，平均住院时间（27．26±9．61）d，无围术期死亡病例，手术时间平均（3．09±1．09） h，术中出血量平均（618．60±366．50） ml，融合节段超过3个的106例（57．61％）。出现各种并发症合计119例（64．67％），按发生的比例依次排列为切口愈合不良、术后疼痛、全身状况不稳定、低血容量、脑脊液漏、神经根损伤和深静脉血栓形成，对所发生的并发症，均给予了积极有效的对应治疗，效果较好。结论老年重度腰椎管狭窄症患者的手术有一定的风险，但并非不能手术，做好术前准备和术后应对预案，可以提高围术期安全性。
目的：探討老年重度腰椎管狹窄癥圍術期特點和術後早期併髮癥的處理方法。方法迴顧性分析我院骨科2008－02至2013－12共184例老年重度腰椎管狹窄癥的病歷資料，總結術前閤併癥、術中齣血量、手術時間、住院時間，觀察術後早期併髮癥的齣現情況，總結處理方法。結果患者平均（68．77±5．76）歲，平均住院時間（27．26±9．61）d，無圍術期死亡病例，手術時間平均（3．09±1．09） h，術中齣血量平均（618．60±366．50） ml，融閤節段超過3箇的106例（57．61％）。齣現各種併髮癥閤計119例（64．67％），按髮生的比例依次排列為切口愈閤不良、術後疼痛、全身狀況不穩定、低血容量、腦脊液漏、神經根損傷和深靜脈血栓形成，對所髮生的併髮癥，均給予瞭積極有效的對應治療，效果較好。結論老年重度腰椎管狹窄癥患者的手術有一定的風險，但併非不能手術，做好術前準備和術後應對預案，可以提高圍術期安全性。
목적：탐토노년중도요추관협착증위술기특점화술후조기병발증적처리방법。방법회고성분석아원골과2008－02지2013－12공184례노년중도요추관협착증적병력자료，총결술전합병증、술중출혈량、수술시간、주원시간，관찰술후조기병발증적출현정황，총결처리방법。결과환자평균（68．77±5．76）세，평균주원시간（27．26±9．61）d，무위술기사망병례，수술시간평균（3．09±1．09） h，술중출혈량평균（618．60±366．50） ml，융합절단초과3개적106례（57．61％）。출현각충병발증합계119례（64．67％），안발생적비례의차배렬위절구유합불량、술후동통、전신상황불은정、저혈용량、뇌척액루、신경근손상화심정맥혈전형성，대소발생적병발증，균급여료적겁유효적대응치료，효과교호。결론노년중도요추관협착증환자적수술유일정적풍험，단병비불능수술，주호술전준비화술후응대예안，가이제고위술기안전성。
Objective To investigate the peroperative characteristics and early complications in senile people with severe lum -bar spinal canal stenosis .Method From february 2008 to December 2013, a retrospective review of 184 patients with severe lumbar canal stenosis treated surgically with decompressional procedure was performed .Of these, 80 males, 104 females aging from 60~86 years (average of 68.77 ±5.76 years).All patrents underwent surgical decompression .Before operation, all cases consulted with in-ternal medical stuff for the proper treatment of concomitant diseases .The preoperative concomitant diseases , intraoperative bleeding volume, operative and hospitalization time were summarized .The appearance and management of complications at early post-operation stage were observed especially .Result The average hospital stay was 27.26 ±9.61 days.No death cases ocurred during peri-opera-tion.The average operative time was 3.09 ±1.09 h.The average intraoperative blood loss was 618.60 ±366.50 ml.106 cases (57.61%) were noted to have over 3 fusion segments.119 cases (64.67%) were noted to have complications which improved by symptomatic treatment.The complications ranked in the following percentage:poor wound healing, pain, poor body condition, hypov-olemia, cerebrospinal fluid leakage , neuroinjury and deep venous thrombosis . All complications were treated effectively . Conclusions There are definite risks in the operation of senile people with severe lumbar spinal canal stenosis .But in condition of controlling concomitant internal disease , treatment with surgical decompression can still play an important role in neurological recovery and improve safety in peroperative period .
