摘要
目的 分析脊髓型颈椎病患者前路术后吞咽困难发生风险及其危险因素。方法 前瞻性纳入2020年2月至2022年10月河南省洛阳正骨医院收治的184例脊髓型颈椎病患者为研究对象,所有患者均接受前路手术,术后对患者进行为期2个月的随访,根据有无发生吞咽困难分为发生组和未发生组,收集两组患者入院时的人口学资料、实验室检查结果等临床资料,采用多因素Logistic回归分析影响前路术后吞咽困难发生的相关因素。结果 随访结束后失访9例,最后共计纳入175例患者。根据有无发生吞咽困难分为发生组46例(26.28%)和未发生组129例(73.72%);发生组患者融合节段为C_(3~4)的占比为56.53%,明显高于未发生组的36.43%,差异有统计学意义(P<0.05);发生组患者的手术时间长于未发生组、术中出血量多于未发生组,上食管括约肌最大开口(UES)大于未发生组,差异均具有统计学意义(P<0.05);经多因素Logistic回归分析结果显示,手术时间短、术中出血量少是吞咽困难发生的保护因素(P<0.05),融合节段为C_(3~4)、UES小是吞咽困难发生危险因素(P<0.05)。结论 脊髓型颈椎病患者前路术后吞咽困难发生率为26.28%。手术时间、术中出血量、UES以及融合节段均为导致吞咽困难发生的相关因素。
Objective To analyze the risk and risk factors of dysphagia in patients with cervical spondylotic myelopathy after anterior surgery.Methods A total of 184 patients with cervical spondylotic myelopathy admitted to Luoyang Orthopedic-tranmatological Hospital of Henan Province from February 2020 to October 2022 were prospectively included as the research objects.All patients underwent anterior surgery and were followed up for two months after operation.According to whether dysphagia occurred or not,they were divided into two groups:occurrence group and non-occurrence group.The clinical data such as demographic data and laboratory test results were collected.The related factors affecting dysphagia after anterior surgery were analyzed by multivariate Logistic regression.Results Nine cases were lost after follow-up,and 175 cases were finally included.According to the occurrence of dysphagia,46 cases(26.28%)were divided into the occurrence group and 129 cases(73.72%)into the non-occurrence group.The proportion of patients with C3-4 fusion segments in the occurrence group was 56.53%,which was significantly higher than 36.43%in the non-occurrence group(P<0.05).The operation time of the occurrence group was significantly longer than that of the non-occurrence group,the intraoperative blood loss was significantly,and the maximum opening of the upper esophageal sphincter(UES)was significantly larger,with statistically significant differences(P<0.05).Multivariate Logistic regression analysis showed that short operation time and less intraoperative blood loss were the protective factors for dysphagia(P<0.05),and C3-4 fusion segments and small UES were the risk factors for dysphagia(P<0.05).Conclusion The incidence of dysphagia in patients with cervical spondylotic myelopathy after anterior approach surgery is 26.28%.Operation time,intraoperative blood loss,UES,and fusion segment are all related factors that lead to dysphagia.
作者
宋仁谦
周英杰
郑怀亮
闫飞鸿
柴旭斌
禚汉杰
张浩浩
黄勇
SONG Ren-qian;ZHOU Ying-jie;ZHENG Huai-liang;YAN Fei-hong;CHAI Xu-bin;ZHUO Han-jie;ZHANG Hao-hao;HUANG Yong(Department of Spinal Surgery,Luoyang Orthopedic-tranmatological Hospital of Henan Province(Henan Orthopedic Hospital),Luoyang 471000,Henan,CHINA)
出处
《海南医学》
CAS
2023年第22期3248-3251,共4页
Hainan Medical Journal
基金
河南省洛阳市科技计划项目(编号:2101041A)。
关键词
脊髓型颈椎病
前路手术
吞咽困难
风险
危险因素
Cervical spondylotic myelopathy
Anterior surgery
Dysphagia
Risk
Risk factor
