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含三种药物混合物的明胶海绵在术中神经根阻滞中的应用以促进腰椎间盘突出症术后早期恢复

Application of Gelatin Sponge Impregnated with a Mixture of 3 Drugs to Intraoperative Nerve Root Block to Promote Early Postoperative Recovery of Lumbar Disc Herniation.

作者信息

Du Jin Peng, Fan Yong, Hao Ding Jun, Huang Yun Fei, Zhang Jia Nan, Yuan Lei Hong

机构信息

Department of Spine Surgery, Xi'an Jiao Tong University-affiliated Hong Hui Hospital, Xi'an City, Shaanxi Province, China; Medical College, Yan'an University, Yan'an City, Shaanxi Province, China.

Department of Spine Surgery, Xi'an Jiao Tong University-affiliated Hong Hui Hospital, Xi'an City, Shaanxi Province, China.

出版信息

World Neurosurg. 2018 Jun;114:e1168-e1173. doi: 10.1016/j.wneu.2018.03.170. Epub 2018 Mar 31.

Abstract

OBJECTIVE

To observe effect of application of gelatin sponge impregnated with a mixture of 3 drugs to intraoperative nerve root block to promote early postoperative recovery of lumbar disc herniation.

METHODS

Retrospective analysis was performed of 265 patients with single-level lumbar disc herniation from January 2013 to October 2017. Patients were divided into intervention and control groups based on intraoperative application of gelatin sponge impregnated with a mixture of 3 drugs. All patients underwent unilateral minimally invasive surgical transforaminal lumbar interbody fusion. Clinical data, including bedridden period, postoperative hospital stay, visual analog scale scores for low back pain and leg pain, Japanese Orthopaedic Association score, postoperative satisfaction questionnaire results, and therapeutic effect, were collected.

RESULTS

There were 136 cases in the intervention group and 129 cases in the control group. The intervention group had significantly shorter bedridden period and postoperative hospital stay than control group (P < 0.05). Visual analog scale scores for low back pain and leg pain at postoperative days 1-10 were significantly lower in the intervention group compared with control group (P < 0.05). The Japanese Orthopaedic Association score at postoperative day 6 and satisfaction at 72 hours postoperatively were significantly higher in the intervention group than in control group (P < 0.05). Clinical effect at postoperative day 6 was significantly better in the intervention group than control group (P < 0.05).

CONCLUSIONS

Application of gelatin sponge impregnated with a mixture of 3 drugs to intraoperative nerve root block can significantly promote early postoperative recovery of lumbar disc herniation and has great short-term clinical efficacy.

摘要

目的

观察应用含三种药物混合物的明胶海绵进行术中神经根阻滞对腰椎间盘突出症术后早期恢复的影响。

方法

回顾性分析2013年1月至2017年10月期间265例单节段腰椎间盘突出症患者。根据术中是否应用含三种药物混合物的明胶海绵将患者分为干预组和对照组。所有患者均接受单侧微创经椎间孔腰椎椎间融合术。收集临床资料,包括卧床时间、术后住院时间、腰腿痛视觉模拟评分、日本骨科协会评分、术后满意度调查问卷结果及治疗效果。

结果

干预组136例,对照组129例。干预组的卧床时间和术后住院时间均显著短于对照组(P<0.05)。干预组术后1-10天的腰腿痛视觉模拟评分显著低于对照组(P<0.05)。干预组术后第6天的日本骨科协会评分及术后72小时的满意度均显著高于对照组(P<0.05)。干预组术后第6天的临床效果显著优于对照组(P<0.05)。

结论

应用含三种药物混合物的明胶海绵进行术中神经根阻滞可显著促进腰椎间盘突出症术后早期恢复,具有良好的短期临床疗效。

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