摘要
目的探讨日间手术模式下开展经皮椎体后凸成形术(PKP)的安全性和可行性。方法回顾性分析2023年1月至2025年1月因骨质疏松性脊柱压缩骨折(OVCF)在中国人民解放军北部战区总医院行PKP手术患者131例,体质量指数(BMI)<30 kg/m^(2),美国麻醉医师协会(ASA)分级Ⅰ~Ⅲ级。根据住院模式不同,分为住院管理组(对照组,n=69)和日间管理组(日间组,n=62)。对照组患者按普通住院流程在骨科病房收治,日间组患者按日间手术流程在日间病房收治:术前经骨科门诊评估和麻醉科门诊术前评估均符合日间手术标准的患者。记录两组患者手术时间、住院时间、住院费用,术后6、24、72 h疼痛视觉模拟评分(VAS),两组患者术后24、72 h睡眠障碍发生率及阿森斯失眠量表(AIS)评分,术后并发症等指标。结果两组手术时间、术后疼痛VAS评分、术后并发症比较差异无统计学意义(P>0.05)。与对照组比较,日间组住院时间、住院费用显著减少,满意度明显增加,差异均有统计学意义(P<0.05)。日间组术后24、72 h睡眠障碍评分显著降低,差异有统计学意义(P<0.05)。结论日间手术模式开展PKP安全可行,可以显著缩短患者住院时间、降低住院费用,改善术后睡眠障碍,促进患者快速康复,提高患者满意度。
Objective To investigate the safety and feasibility of percutaneous kyphoplasty(PKP)in the ambulatory surgery mode.Methods A retrospective analysis was performed,131 patients,with body mass index(BMI)<30 kg/m^(2),of American Society of Anesthesiologists(ASA)physical statusⅠ-Ⅲ,undergoing PKP in General Hospital of Northern Theater Command from January 2023 to January 2025 for osteoporotic vertebral compression fracture(OVCF).According to different hospitalization modes,the patients were divided into the inpatient management group(control group,n=69)and the day-case management group(day-case group,n=62).Patients in the control group were admitted to the orthopedic ward according to the ordinary inpatient process,while patients in the day-case group were admitted to the day-case ward according to the day-case surgery process:patients who met the day-case surgery criteria after being evaluated at the orthopedic outpatient department and the preoperative evaluation at the anesthesiology outpatient department before surgery.The operative time,hospital stay,hospital cost,visual analogue scale(VAS)score at 6,24 and 72 h after surgery,incidence of sleep disorders,score of Athens insomnia scale(AIS),postoperative complications and other indicators of patients in both groups were recorded.Results Both groups of operations were successfully completed.There was no significant difference in operation time,postoperative VAS score and postoperative complications between the two groups(P>0.05).Compared with the control group,the length of hospitalization and hospitalization cost in the day-case group were significantly reduced,and the satisfaction was significantly increased in the day-case group,with statistical significance(P<0.05).Compared with the control group,the sleep disorder score of the day-case group was significantly decreased at 24 and 72 h after surgery,with statistical significance(P<0.05).Conclusion It is safe and feasible to conduct PKP in ambulatory surgery mode,which can significantly shorten the hospital stay of patients,reduce hospitalization costs,improve postoperative sleep disorders,enhance rapid recovery of patients and improve patient satisfaction.
作者
谢宇飞
宋丹丹
崔小鹏
XIE Yufei;SONG Dandan;CUI Xiaopeng(Department of Anesthesiology,General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《麻醉安全与质控》
2025年第6期462-466,共5页
Perioperative Safety and Quality Assurance
基金
北部战区总医院自主科研项目(ZZKY2024075)。
关键词
日间手术
经皮椎体后凸成形术
术后睡眠障碍
骨质疏松性脊柱压缩骨折
术后并发症
daytime surgery
percutaneous kyphoplasty
postoperative sleep disorder
osteoporotic vertebral compression fracture
postoperative complications
