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气管牵引运动可降低颈椎前路手术后吞咽困难的发生。

Tracheal traction exercise reduces the occurrence of postoperative dysphagia after anterior cervical spine surgery.

机构信息

Department of Orthopedics, Shanghai Changhai Hospital, Shanghai, China.

出版信息

Spine (Phila Pa 1976). 2012 Jul 1;37(15):1292-6. doi: 10.1097/BRS.0b013e3182477f26.

Abstract

STUDY DESIGN

We designed a novel anterior cervical spine surgery preoperative treatment comprising mechanical trachea/esophagus traction and compared the postoperative outcome regarding dysphagia with nontreated patients.

OBJECTIVE

We investigated whether the newly developed preoperative tracheal/esophageal traction exercise (TTE) treatment has an effect on postoperative dysphagia after anterior cervical spine surgery.

SUMMARY OF BACKGROUND DATA

Dysphagia is a postoperative complication that occurs after anterior cervical spine surgery, and known treatments are perioperative application of methylprednisolone, monitoring of endotracheal tube cuff pressure, and the use of low-profile plates. METHODS.: We compared the neck disability index, visual analogue scale scores for arm and neck pain, and Bazaz dysphagia scores, a dysphagia index, of 2 randomized groups, 1 week, 3 weeks, 6 weeks, 3 months, and 6 months after cervical spine surgery. One group received TTE treatment for 3 consecutive days before surgery, whereas the control group did not. RESULTS.: In the first week after operation, the Bazaz dysphagia scores for patients with second- to fourth-level fusions in the TTE group were significantly better than that in the control group (P = 0.000 for second- and third-level fusions and P = 0.013 for fourth-level fusion). Also at 3 weeks after surgery, the second- to fourth-level fusion patients in the TTE group had better Bazaz scores than those in the control group (P = 0.000 for second- and third-level fusions and P = 0.004 for fourth-level fusion). There was no significant difference of neck disability index and visual analogue scale scores between the 2 groups.

CONCLUSION

Dysphagia could be reduced in patients with multiple-level fusion after anterior cervical spine surgery by preoperative TTE treatment.

摘要

研究设计

我们设计了一种新的颈椎前路手术术前治疗方法,包括机械气管/食管牵引,并比较了术后吞咽困难的治疗效果。

目的

研究新开发的术前气管/食管牵引运动(TTE)治疗对颈椎前路手术后吞咽困难的影响。

背景资料概述

吞咽困难是颈椎前路手术后的一种术后并发症,已知的治疗方法包括围手术期应用甲基强的松龙、监测气管内管套囊压力和使用低轮廓板。

方法

我们比较了 2 个随机分组患者的颈椎手术后 1 周、3 周、6 周、3 个月和 6 个月的颈部残疾指数、手臂和颈部疼痛的视觉模拟评分以及吞咽困难指数巴扎兹吞咽困难评分。一组患者在手术前连续 3 天接受 TTE 治疗,而对照组患者未接受 TTE 治疗。

结果

术后第 1 周,TTE 组第 2-4 级融合患者的巴扎兹吞咽困难评分明显优于对照组(第 2-3 级融合 P = 0.000,第 4 级融合 P = 0.013)。术后 3 周时,TTE 组第 2-4 级融合患者的巴扎兹评分也优于对照组(第 2-3 级融合 P = 0.000,第 4 级融合 P = 0.004)。两组的颈部残疾指数和视觉模拟评分无显著差异。

结论

颈椎前路手术后多节段融合患者术前 TTE 治疗可减轻吞咽困难。

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