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腰椎侧弯前路矫正手术史女性孕期生活质量、剖宫产率及麻醉情况:一项病例对照研究

Quality of Life During Pregnancy, Caesarean Section Rate, and Anesthesia in Women with a History of Anterior Correction Surgery for Lumbar Scoliosis: A Case-Control Study.

作者信息

Cao Yun, Shu Shibin, Jing Wenting, Zhu Zezhang, Qiu Yong, Bao Hongda

机构信息

Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China (mainland).

Department of Spine Surgery, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China (mainland).

出版信息

Med Sci Monit. 2020 Oct 17;26:e926960. doi: 10.12659/MSM.926960.

Abstract

BACKGROUND This study investigated the prevalence and severity of low back pain (LBP), caesarean section (C-section) rate, and the anesthesia approaches among lumbar scoliosis patients undergoing anterior correction surgery, and compared them with a healthy control cohort. MATERIAL AND METHODS The inclusion criteria for adolescent idiopathic scoliosis (AIS) patients were: presence of lumbar scoliosis, history of 1 or more pregnancies after surgery, and underwent anterior-only surgery. Healthy women with a history of 1 pregnancy were included as the control group. We recorded the type of delivery, neonatal birth weight, and perinatal complications. The quality of life was also evaluated. RESULTS New-onset LBP was reported in 65.6% of AIS patients, significantly higher than in the control group (p<0.001). C-section was performed in 11 scoliosis patients (34.4%) and 25 healthy controls (31.25%), and the rates were not significantly different between groups (P=0.75). No serious perinatal complications were reported in either group. General anesthesia was used for all C-section AIS patients. The rate of successful neuraxial anesthesia in the control group was significantly higher (P<0.001). CONCLUSIONS Compared with the healthy control group, lumbar AIS patients did not experience a higher risk of perinatal complications or C-section rate after anterior surgical correction, but general anesthesia was more commonly used than neuraxial regional anesthesia. LBP was more frequently observed in the post-operative AIS patients.

摘要

背景 本研究调查了接受前路矫正手术的腰椎侧弯患者中腰痛(LBP)的患病率和严重程度、剖宫产(C -section)率以及麻醉方法,并将其与健康对照队列进行比较。

材料与方法 青少年特发性脊柱侧弯(AIS)患者的纳入标准为:存在腰椎侧弯、手术后有 1 次或更多次妊娠史且仅接受了前路手术。有 1 次妊娠史的健康女性被纳入对照组。我们记录了分娩类型、新生儿出生体重和围产期并发症。还评估了生活质量。

结果 65.6%的 AIS 患者报告有新发腰痛,显著高于对照组(p<0.001)。11 例脊柱侧弯患者(34.4%)和 25 例健康对照者(31.25%)进行了剖宫产,两组发生率无显著差异(P=0.75)。两组均未报告严重的围产期并发症。所有剖宫产的 AIS 患者均采用全身麻醉。对照组腰麻成功的比例显著更高(P<0.001)。

结论 与健康对照组相比,腰椎 AIS 患者在前路手术矫正后未出现更高的围产期并发症风险或剖宫产率,但全身麻醉的使用比椎管内区域麻醉更为普遍。术后 AIS 患者中腰痛更为常见。

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