摘要
目的探讨基于Caprini风险评估的快速康复理念对老年患者腰椎术后下肢运动功能和深静脉血栓(DVT)的影响。方法收集2021年3月至2024年2月于首都医科大学附属北京积水潭医院接受腰椎手术治疗的264例老年患者的临床资料,按围手术期管理方式的不同将患者分为观察组(n=136,实施基于Caprini风险评估的快速康复干预模式)和对照组(n=128,实施常规的管理和预防)。主要观察指标为出院时针对下肢的Fugel-Meyer运动功能评分和术后住院期间下肢DVT的发生率,次要观察指标为手术相关指标和术后住院期间继发感染情况。结果两组患者的手术类型、手术时长、术中低体温的发生率和术中出血量比较,差异均无统计学意义(P﹥0.05)。观察组患者出院时Fugel-Meyer运动功能评分明显高于对照组患者,差异有统计学意义(P﹤0.01)。术后住院期间,观察组患者下肢DVT的发生率为1.5%(2/136),低于对照组患者的7.0%(9/128),差异有统计学意义(P﹤0.05);两组患者继发感染的发生率比较,差异无统计学意义(P﹥0.05)。结论基于Caprini风险评估的快速康复理念可以明显改善老年腰椎手术患者下肢运动功能评分,进而降低下肢DVT的发生风险,值得临床推广。
Objective To investigate the impact of rapid rehabilitation concept based on Caprini risk assessment on lower extremity mobility and deep vein thrombosis(DVT)in elderly patients after lumbar spine surgery.Method The clinical data of 264 elderly patients who underwent lumbar spine surgery at Beijing Jishuitan Hospital,Capital Medical University from March 2021 to February 2024 were collected.The patients were divided into observation group(n=136,implementing rapid rehabilitation intervention model based on Caprini risk assessment)and control group(n=128,implementing routine management and prevention)according to different perioperative management methods.The main observation indicators were the Fugel Meyer motor function score of the lower extremity at discharge and the incidence of lower extremity DVT during postoperative hospitalization,the secondary observation indicators were surgery related indicators and secondary infections during postoperative hospitalization.Result There were no statistically significant differences in the surgical type,duration,incidence of intraoperative hypothermia,and intraoperative bleeding between the two groups of patients(P>0.05).The Fugel Meyer motor function score at discharge of the observation group patients was significantly higher than that of the control group patients,and the difference was statistically significant(P<0.01).During postoperative hospitalization,the incidence of lower extremity DVT in the observation group was 1.5%(2/136),which was lower than the 7.0%(9/128)in the control group,and the difference was statistically significant(P<0.05);there was no statistically significant difference in the incidence of secondary infections between the two groups of patients(P>0.05).Conclusion Rapid rehabilitation concept based on Caprini risk assessment can significantly improve lower extremity motor function scores in elderly patients undergoing lumbar spine surgery,thereby reducing the risk of lower extremity DVT,which is worthy of clinical promotion.
作者
李盼
黄洁
韩莹
杨菁蕊
Li Pan;Huang Jie;Han Ying;Yang Jingrui(Department of Spinal Surgery,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China;Spinal Surgery VTE Treatment Group,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)
出处
《血管与腔内血管外科杂志》
2025年第7期893-897,共5页
Journal of Vascular and Endovascular Surgery
关键词
Caprini评分
快速康复
老年
腰椎
下肢
运动功能
深静脉血栓
Caprini score
rapid rehabilitation
elderly
lumbar vertebra
lower extremity
motor function
deep vein thrombosis
