比较椎间盘切除术期间使用手术刀和电灼技术切断腰椎间盘内层的术中和术后并发症。
Comparing the intraoperative and postoperative complications of the scalpel and electrocautery techniques for severing the inner layers of the lumbar disc during discectomy surgery.
作者信息
Hajilo Parisa, Imani Behzad, Zandi Shirdel, Mehrafshan Ali
机构信息
Student Operating Room, Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran.
Department of Operating Room, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran.
出版信息
Front Surg. 2023 Sep 28;10:1264519. doi: 10.3389/fsurg.2023.1264519. eCollection 2023.
BACKGROUND
Due to the sensitivity of the surgical site and a higher probability of injury, the use of a scalpel and electrocautery to create an incision in the spine is discussed. In this study, we will compare the intraoperative and postoperative complications of the scalpel and electrocautery techniques for severing the inner layers of the lumbar disc during discectomy surgery.
MATERIALS AND METHODS
This study was conducted in Iran as a randomized controlled trial with double-blinding (1,401). Sixty candidates for spine surgery were randomly divided into two groups of 30 using electrocautery (A) and a scalpel (B) based on available sampling. The VAS scale was used to assess postoperative pain. The duration of the incision and intraoperative blood loss were recorded. The infection and fluid secretions were determined using the Southampton scoring scale. Utilizing the Manchester scar scale, the wound healing status was evaluated. The SPSS version 16 software was used for data analysis (-test, Mann-Whitney , ANOVA).
RESULTS
The electrocautery group had substantially lower bleeding, pain, and wound healing rates than the scalpel group ( > 0.05). However, the electrocautery group had significantly longer surgical times, more secretions, and a higher infection rate than the scalpel group ( > 0.05). In terms of demographic and clinical characteristics, there was no significant difference between the two groups ( < 0.05).
CONCLUSION
Electrocautery reduces postoperative hemorrhage and, potentially, postoperative pain in patients. However, as the duration of surgery increases, so does the duration of anesthesia, and patient safety decreases. Additionally, the risk of infection increases in the electrocautery group compared to the scalpel group, and the rate of wound healing decreases.
CLINICAL TRIAL REGISTRATION
https://www.irct.ir/, identifier (IRCT20230222057496N1).
背景
由于手术部位的敏感性以及更高的受伤概率，人们讨论了使用手术刀和电灼术在脊柱上做切口的情况。在本研究中，我们将比较椎间盘切除术期间使用手术刀和电灼术切断腰椎间盘内层的术中及术后并发症。
材料与方法
本研究在伊朗作为一项双盲随机对照试验进行（1401例）。60名脊柱手术候选者根据可用抽样法随机分为两组，每组30人，分别使用电灼术（A组）和手术刀（B组）。采用视觉模拟评分量表（VAS）评估术后疼痛。记录切口持续时间和术中失血量。使用南安普敦评分量表确定感染和液体分泌情况。利用曼彻斯特瘢痕量表评估伤口愈合状况。使用SPSS 16版软件进行数据分析（t检验、曼-惠特尼检验、方差分析）。
结果
电灼术组的出血、疼痛和伤口愈合率明显低于手术刀组（P>0.05）。然而，电灼术组的手术时间明显更长，分泌物更多，感染率高于手术刀组（P>0.05）。在人口统计学和临床特征方面，两组之间无显著差异（P<0.05）。
结论
电灼术可减少患者术后出血，并可能减轻术后疼痛。然而，随着手术时间的增加，麻醉时间也会增加，患者安全性降低。此外，与手术刀组相比，电灼术组的感染风险增加，伤口愈合率降低。
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