气管食管推移训练对颈椎前路手术的影响

Influence of trachea and esophagus movement training on patients undergoing anterior cervical surgery

目的探讨气管食管推移训练对颈椎前路手术患者术中及术后症状的影响。方法选取我院2019年1-12月收治的122例拟行颈椎前路椎间盘切除固定融合术(anterior cervical discectomy and fusion,ACDF)的患者,采用随机数字表法将其分为对照组53例和观察组69例,对照组实施颈椎前路手术常规护理,观察组在对照组基础上术前给予气管食管推移训练,比较2组手术中出血量、术中心率与血压波动情况、手术时间、住院时间,以及术后吞咽困难程度(water swallow test,WST)评分、咽喉疼痛程度评分、日本骨科协会评估治疗(Japanese orthopaedic association scores,JOA)评分、腰椎功能障碍指数(oswertry disability index,ODI)。结果观察组术中出血量、术中心率及血压波动幅度均少于对照组(t=6.423,P<0.001;t=8.453,P<0.001;t=9.228,P<0.001)、手术时间短于对照组(t=4.328,P<0.001),术后咽喉部疼痛评分、WST评分、JOA评分及ODI均低于对照组(P<0.05)。结论气管食管推移训练可增加患者术中牵拉耐受,提高手术效率。气管食管推移训练可减少术后咽喉部症状,提高患者生活质量。

Objective To explore the influence of trachea and esophagus movement training on the intraoperative and postoperative symptoms of patients undergoing anterior cervical surgery.Methods Totally 122 patients undergoing anterior cervical discectomy and fusion(ACDF)in 2019 were randomly divided into a control group of 53 and an observation group of 69.Both groups were given routine nursing,while the observation group was additionally provided with trachea and esophagus movement training.The blood loss during the operation,operation duration,intraoperative heart rate and blood pressure fluctuation,and hospital stay were compared between the two groups.And they were also evaluated the postoperative dysphagia by water swallow test(WST),upper limb and throat pain by visual analogue scale/score(VAS),Japanese orthopaedic association scores(JOA),and oswetry dysfunction index(ODI).Results The intraoperative blood loss,intraoperative heart rate and blood pressure fluctuation were less than that of the control group(t=6.423,P<0.001;t=8.453,P<0.001;t=9.228,P<0.001),the operation time was lower than that of the control group(t=4.328,P<0.001),as well as the VAS score,WST score,JOA score and ODI of the observation group were all significantly lower than that of the control group(P<0.05).Conclusion Trachea-esophageal training can increase the tolerance of intraoperative traction and improve the efficiency of operation,as well as reduce postoperative throat symptoms and improve the life quality of patients.