摘要
目的对中山市中医院颈椎骨折合并脊髓损伤手术患者进行回顾性调查分析,研究早期8 h内救治对患者功能恢复及并发症的影响。方法选取2020年1月—2022年1月中山市中医院骨科收治的颈椎骨折并脊髓损伤手术患者36例为研究对象,对其临床资料进行回顾性分析。根据发病至手术时间分别将≤8 h手术的患者纳入观察组(n=16)、9~24 h手术的患者纳入对照组(n=20),应用视觉模拟评分法(visual analogue scale,VAS)、日本骨科协会评分法(Japanese orthopaedic association,JOA)、日常生活活动能力量表(activity of daily living,ADL)、焦虑自评量表(self-rating anxiety scale,SAS)等评价患者功能恢复情况,并比较2组并发症发生率、住院时间及住院费用。结果2组术后1周及术后4周VAS、JOA、ADL各评分均较术前有改善,术后4周评分改善更明显,差异有统计学意义(P<0.05),组间比较观察组优于对照组,差异有统计学意义(P<0.05);而在SAS评分上,2组术后1周与术前对比以及组间比较均差异无统计学意义(P>0.05),术后4周对照组SAS评分仍无改善,差异无统计学意义(P>0.05),而观察组评分较术前及术后1周改善,且优于对照组,差异有统计学意义(P<0.05)。观察组平均住院时间为12.50(9.00,31.25)d,低于对照组的42.00(27.75,69.25)d,差异有统计学意义(P<0.001);观察组平均住院费用为5.92(4.20,7.73)万元,低于对照组的10.06(8.46,13.41)万元,差异有统计学意义(P<0.001)。在并发症分析中,肺炎及尿路感染为2组患者的高发并发症,且观察组并发症发生率为43.8%,低于对照组的85.0%,差异有统计学意义(P<0.05)。结论对颈椎骨折合并脊髓损伤需手术患者,早期8 h内实施手术救治能更好地改善患者的预后,同时降低并发症的发生率,缩短住院时间并减少住院费用。
Objective To conduct a retrospective investigation and analysis on patients undergoing cervical spine fracture combined with spinal cord injury surgery in Zhongshan Traditional Chinese Medical Hospital,and to study the impact of early treatment within 8 hours on the functional recovery and complications of the patients.Methods A total of 36 patients with cervical spine fractures and spinal cord injuries who underwent surgery and were admitted to the department of orthopedics of Zhongshan Traditional Chinese Medical Hospital from January 2020 to January 2022 were selected as the research subjects,and their clinical data were retrospectively analyzed.According to the time from the onset to the operation,patients who underwent surgery within≤8 hours were respectively included in the observation group(n=16),and patients who underwent surgery within 9~24 hours were respectively included in the control group(n=20).Functional recovery was assessed using the visual analogue scale(VAS),Japanese orthopaedic association(JOA)score,activity of daily living(ADL)scale,and self-rating anxiety scale(SAS).The incidence of complications,length of hospital stay,and hospitalization costs were compared between the two groups.Results The scores of VAS,JOA and ADL in both groups at 1 week and 4 weeks after the operation were improved compared with those before the operation,the improvement of the score at 4 weeks after the operation was more obvious,and the differences were statistically significant(P<0.05).The comparison between groups showed that the observation group was better than the control group,and the differences were statistically significant(P<0.05).In terms of SAS scores,there was no statistically significant difference between the two groups 1 week after the operation and before the operation,as well as between the groups(P>0.05).4 weeks after the operation,the SAS score of the control group still did not improve,and the differences were not statistically significant(P>0.05),while the score of the observation group improved compared with that before the operation and one week after the operation,and was better than that of the control group,and the differences were statistically significant(P<0.05).The average hospital stay of the observation group was 12.50(9.00,31.25)days,which was lower than that of the control group[42.00(27.75,69.25)days],and the difference was statistically significant(P<0.001).The average hospitalization cost of the observation group was 59200(42000,77300)yuan,which was lower than that of the control group[10600(84600,134100)yuan],and the difference was statistically significant(P<0.001).In the complication analysis,pneumonia and urinary tract infection were the high-incidence complications of the two groups of patients.Moreover,the incidence of complications in the observation group was 43.8%,which was lower than 85.0%in the control group,and the difference was statistically significant(P<0.05).Conclusion For patients with cervical fracture combined with spinal cord injury requiring surgery,surgical treatment within 8 hours in the early stage can better improve the prognosis of patients,reduce the incidence of complications,shorten the hospital stay and reduce the hospitalization costs.
作者
郑碧珠
李玖利
叶家盛
ZHENG Bizhu;LI Jiuli;YE Jiasheng(Department of Orthopedics,Zhongshan Traditional Chinese Medical Hospital,Zhongshan Guangdong 528400,China;Department of Rehabilitation,Zhongshan Traditional Chinese Medical Hospital,Zhongshan Guangdong 528400,China)
出处
《中国卫生标准管理》
2025年第11期184-188,共5页
China Health Standard Management
基金
广东省医学科学技术研究基金项目(B2022045)。
关键词
颈椎骨折
脊髓损伤
手术
回顾性分析
并发症
预后
cervical spine fracture
spinal cord injury
surgery
retrospective analysis
complications
prognosis
