ERAS模式在经皮椎间孔镜髓核摘除术中的应用

Application of ERAS model in percutaneous endoscopic transforaminal discectomy

目的评估加速康复外科(ERAS)模式在经皮椎间孔镜髓核摘除术(PETD)治疗单节段腰椎间盘突出症(LDH)中的应用价值。方法将2018年1月至2019年10月山西省阳泉市第一人民医院收治的60例LDH患者纳入研究,患者均采用PETD治疗。根据住院日期单双号将患者分为传统组和ERAS组(n=30),分别采用传统模式和ERAS模式进行围手术期管理。比较两组患者手术时间、离床活动时间、术后住院时间及并发症发生情况,采用下肢痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)及改良MacNab疗效评定标准评价疗效。结果ERAS组手术时间、离床活动时间、术后住院时间、术后3 d VAS评分、ODI均优于传统组(P<0.05),两组术后1个月VAS评分及ODI、MacNab优良率及并发症发生率相似(P>0.05)。结论在PETD治疗LDH围手术期间应用ERAS模式,患者下床活动时间早,住院时间短,有利于术后早期疼痛缓解和快速康复。

Objective To evaluate the applicable value of enhancing recovery after surgery(ERAS)in percutaneous endoscopic transforaminal discectomy(PETD)for the treatment of single-segment lumbar disc herniation(LDH).Methods A total of 60 LDH patients treated in the First People's Hospital of Yangquan from January 2018 to October 2019 were divided into two groups,ERAS group and traditional group,according to single and double hospitalization date(n=30).Patients in traditional group underwent traditional model during perioperation management,while patients in ERAS group were performed perioperation management with ERAS model.Operation time,ambulatory time,postoperative hospital stay and complications were compared between two groups.Clinical effects were evaluated by visual analogue scale(VAS)score of lower extremity pain,Oswestry disability index(ODI)and modified MacNab efficacy evaluation criteria.Results Operation time,ambulatory time,postoperative hospital stay,VAS score and ODI at 3 d after the surgery in ERAS group were better than those in traditional group(P<0.05),while VAS score,ODI,excellent and good rate of MacNab standard at 1 month postoperatively,and incidence of complications were similar in two groups(P>0.05).Conclusion Perioperative application of ERAS model in PETD for LDH is conducive to the relief of early postoperative pain and the rapid recovery of patients with shorter ambulatory time and less postoperative hospital stay.