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弥漫性特发性骨肥厚对颈椎脊髓损伤患者营养状况、神经功能结局及围手术期并发症的影响

The Impact of Diffuse Idiopathic Skeletal Hyperostosis on Nutritional Status, Neurological Outcome, and Perioperative Complications in Patients with Cervical Spinal Cord Injury.

作者信息

Shimizu Tomoaki, Suda Kota, Harmon Satoko Matsumoto, Komatsu Miki, Ota Masahiro, Ushirozako Hiroki, Minami Akio, Takahata Masahiko, Iwasaki Norimasa, Takahashi Hiroshi, Yamazaki Masashi

机构信息

Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, 3-1 Higashi 4 Minami 1, Bibai 072-0015, Hokkaido, Japan.

Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo 060-0815, Hokkaido, Japan.

出版信息

J Clin Med. 2023 Sep 1;12(17):5714. doi: 10.3390/jcm12175714.

Abstract

This retrospective study aimed to investigate the characteristics of patients with cervical spinal cord injuries (CSCI) with diffuse idiopathic skeletal hyperostosis (DISH). We included 153 consecutive patients with CSCI who underwent posterior decompression and fusion surgery. The patients were divided into two groups based on the presence of DISH. Patient characteristics, neurological status on admission, nutritional status, perioperative laboratory variables, complications, neurological outcomes at discharge, and medical costs were compared between the groups. The DISH group (n = 24) had significantly older patients (72.1 vs. 65.9, = 0.036), more patients with low-impact trauma (62.5% vs. 34.1%, = 0.009), and a lower preoperative prognostic nutritional index on admission (39.8 vs. 42.5, = 0.014) than the non-DISH group (n =129). Patients with DISH had significantly higher rates of ventilator management (16.7% vs. 3.1%, = 0.022) and pneumonia (29.2% vs. 8.5%, = 0.010). There was no significant difference in medical costs and neurological outcomes on discharge. Patients with CSCI and DISH were older, had poor nutritional status, and were prone to postoperative respiratory complications, while no differences were found between the neurological outcomes of patients with CSCI with and without DISH.

摘要

这项回顾性研究旨在调查患有弥漫性特发性骨肥厚(DISH)的颈脊髓损伤(CSCI)患者的特征。我们纳入了153例连续接受后路减压融合手术的CSCI患者。根据是否存在DISH将患者分为两组。比较两组患者的特征、入院时的神经状态、营养状况、围手术期实验室指标、并发症、出院时的神经功能结局及医疗费用。DISH组(n = 24)患者的年龄显著更大(72.1岁对65.9岁,P = 0.036),低能量创伤患者更多(62.5%对34.1%,P = 0.009),入院时术前预后营养指数更低(39.8对42.5,P = 0.014),相比于非DISH组(n = 129)。患有DISH的患者机械通气管理率(16.7%对3.1%,P = 0.022)和肺炎发生率(29.2%对8.5%,P = 0.010)显著更高。医疗费用和出院时的神经功能结局无显著差异。患有CSCI和DISH的患者年龄更大,营养状况较差,术后易发生呼吸并发症,而患有和未患有DISH的CSCI患者的神经功能结局未发现差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04d4/10488386/578bb6904a2a/jcm-12-05714-g001.jpg

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