加速康复外科模式下经皮椎体后凸成形术在Kummell病中的应用效果

Application effect of percutaneous kyphoplasty in Kummell′s disease under the mode of enhance recovery after surgery

目的探讨加速康复外科(ERAS)模式对经皮椎体后凸成形术(PKP)治疗Kummell病效果的影响。方法选取2018年3月至2020年12月福建省立医院南院骨科收治的53例Kummell病患者作为研究对象,根据干预方式不同将患者分为观察组(28例)与对照组(25例)。观察组采用ERAS模式下PKP治疗,对照组采用常规PKP治疗。比较两组的手术指标、视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)、术后焦虑症状及并发症发生率。结果观察组患者的术后卧床时间及住院天数短于对照组,差异有统计学意义(P<0.05),两组的手术时长比较,差异无统计学意义(P>0.05)。观察组术后第7天的VAS评分、ODI评分低于对照组,差异有统计学意义(P<0.05)。观察组患者的术后焦虑症状发生率低于对照组,差异有统计学意义(P<0.05);观察组的术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论ERAS模式应用于PKP治疗Kummell病,可减轻疼痛、降低并发症及焦虑症状的发生率,并加速术后的康复。

Objective To investigate the effect of accelerated rehabilitation surgery(ERAS)on percutaneous kyphoplasty(PKP)for Kummell's disease.Methods Fifty-three patients with Kummell's disease admitted to the Department of Orthopedics,South Branch of Fujian Provincial Hospital from March 2018 to December 2020 were selected as the study objects.According to different intervention methods,the patients were divided into observation group(28 cases)and control group(25 cases).The observation group was treated with PKP under ERAS model,and the control group was treated with conventional PKP.Surgical indicators,visual analogue scale(VAS)score,Oswestry disability index(ODI),postoperative anxiety symptoms and complication rate were compared between the two groups.Results The postoperative bed time and hospitalization days of the observation group were shorter than those of the control group,the differences were statistically significant(P<0.05),while the operative duration of the two groups was not statistically significant(P>0.05).VAS scores and ODI scores of the observation group were lower than those of the control group on the 7th day after surgery,and the differences were statistically significant(P<0.05).The incidence of postoperative anxiety symptoms in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion The application of ERAS model in PKP treatment of Kummell disease can reduce the incidence of pain,complications and anxiety symptoms,and accelerate the postoperative rehabilitation.