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[对老年组患者进行两级腰椎融合术后使用加速康复计划的结果评估。]

[Evaluation of the results of using the accelerated recovery program after performing two-level lumbar spinal fusion in patients of an older age group.].

作者信息

Byvaltsev V A, Goloborodko V Y, Kalinin A A, Satardinova E E, Pestryakov Y Y, Shepelev V V, Biryuchkov M Y

机构信息

Irkutsk State Medical University, 1 Krasnogo Vosstaniya str., Irkutsk 664003, Russian Federation, e mail:

Clinical Hospital «Russian Railways-Medicine», 10 Botkina str., Irkutsk 664005, Russian Federation.

出版信息

Adv Gerontol. 2020;33(5):964-971.

Abstract

The aim of the study was to evaluate the results of using the accelerated recovery program after performing two-level lumbar spinal fusion in patients of an older age group. The results of surgical treatment of 29 patients older than 65 years with multisegmental degenerative diseases of the lumbar region, who performed minimally invasive two-level rigid stabilization using the concept of «accelerated recovery program» (PAR), were retrospectively studied. We studied the technical features of surgical interventions, the specificity of the postoperative period, the number of adverse outcomes of anesthetic benefits and perioperative surgical complications, the frequency of repeated hospitalizations for 90 days. Clinical parameters were used to evaluate the effectiveness of PAR: the level of pain in the area of operation according to the visual analogue scale (VAS) during hospitalization, the quality of life of patients on the SF-36 questionnaire, and patient satisfaction with the result of treatment using the Macnab scale. As a result, it was established that the introduced PAR after performing two-level lumbar spinal fusion in patients of an older age group provides the minimum number of adverse consequences of anesthesiological aid and perioperative surgical complications, a significant restoration of the quality of life and high patient satisfaction with the treatment.

摘要

本研究的目的是评估在老年患者中进行两级腰椎融合术后采用加速康复计划的效果。回顾性研究了29例65岁以上患有腰椎多节段退行性疾病的患者,他们采用“加速康复计划”(PAR)的理念进行了微创两级刚性固定手术。我们研究了手术干预的技术特点、术后时期的特殊性、麻醉益处和围手术期手术并发症的不良后果数量、90天内再次住院的频率。使用临床参数评估PAR的有效性:住院期间根据视觉模拟量表(VAS)评估手术区域的疼痛程度、使用SF-36问卷评估患者的生活质量以及使用Macnab量表评估患者对治疗结果的满意度。结果表明,在老年患者中进行两级腰椎融合术后引入PAR可使麻醉辅助和围手术期手术并发症的不良后果数量降至最低,显著恢复生活质量并使患者对治疗高度满意。

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