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快速康复营养支持对微创腰椎手术患者功能恢复及住院时间的影响。

Influence of rapid recovery nutritional support on functional recovery and hospitalization duration in patients undergoing minimally invasive lumbar surgery.

作者信息

Feng Yiyun, Ma Yanan, Lai Jifang, Wang Chunyan, Ma Xiaoyan, Liu Jing

机构信息

Department of Spine Surgery, Elderly Orthopedics, Affiliated Hospital of Gansu University of Chinese Medicine No. 732, Jiayu Pass West Road, Chengguan District, Lanzhou 730020, Gansu, China.

Department of Joint Movement, Affiliated Hospital of Gansu University of Chinese Medicine No. 732, Jiayu Pass West Road, Chengguan District, Lanzhou 730020, Gansu, China.

出版信息

Am J Transl Res. 2023 Dec 15;15(12):7023-7034. eCollection 2023.

Abstract

OBJECTIVE

To examine the impact of a nutrition support model, specifically focused on rapid recovery, on postoperative recovery in patients with degenerative lumbar spinal stenosis who underwent minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).

METHODS

A retrospective analysis was conducted, utilizing the medical records of 114 patients with degenerative lumbar spinal stenosis who underwent MIS-TLIF at the Affiliated Hospital of Gansu University of Chinese Medicine from February 2020 to October 2022. Among these patients, 63 individuals received a nutrition support model based on the concept of rapid recovery, comprising the observation group, while the remaining 51 patients received conventional postoperative support, forming the control group. The study compared the post-intervention lumbar function recovery, postoperative pain score, perioperative hospital stay, and patient satisfaction with nursing work between the two groups.

RESULTS

There was no statistically significant difference in the Japanese Orthopaedic Association (JOA) score and Oswestry Disability Index (ODI) at 6 months after the intervention between the two groups (P>0.05). Similarly, there was no statistically significant difference in the modified Barthel index and visual analog scale scores at 6 months after the intervention between the two groups (P>0.05). In terms of operation time and intraoperative blood loss, there was no statistically significant difference observed between the observation group and the control group (P>0.05). However, when compared to the control group, the observation group showed significant shorter hospital stay and time to ambulation after the intervention, leading to a decrease in treatment cost (P<0.01). Multivariate logistic regression analysis revealed that age, history of diabetes, nursing plan, operation time, and preoperative JOA score were identified as independent risk factors for prolonged hospital stay (P<0.05).

CONCLUSION

The nutrition support model, which is based on the concept of rapid recovery, has been found to have several benefits for patients with degenerative lumbar spinal stenosis undergoing MIS-TLIF. These benefits include reducing the hospital stay, treatment cost, and the time to ambulation. Additionally, logistic regression analysis has identified several independent risk factors that can affect the length of hospital stay. These risk factors include age, history of diabetes, nursing plan, operation time, and preoperative JOA score.

摘要

目的

探讨一种特别注重快速康复的营养支持模式对接受微创经椎间孔腰椎椎体间融合术(MIS-TLIF)的退变性腰椎管狭窄症患者术后恢复的影响。

方法

进行回顾性分析,利用2020年2月至2022年10月在甘肃中医药大学附属医院接受MIS-TLIF的114例退变性腰椎管狭窄症患者的病历。在这些患者中,63例接受了基于快速康复理念的营养支持模式,组成观察组,其余51例患者接受常规术后支持,形成对照组。该研究比较了两组干预后腰功能恢复情况、术后疼痛评分、围手术期住院时间以及患者对护理工作的满意度。

结果

两组干预后6个月时,日本骨科协会(JOA)评分和Oswestry功能障碍指数(ODI)无统计学显著差异(P>0.05)。同样,两组干预后6个月时改良Barthel指数和视觉模拟量表评分也无统计学显著差异(P>0.05)。在手术时间和术中出血量方面,观察组与对照组之间未观察到统计学显著差异(P>0.05)。然而,与对照组相比,观察组干预后的住院时间和下床活动时间显著缩短,治疗费用降低(P<0.01)。多因素逻辑回归分析显示,年龄、糖尿病史、护理方案、手术时间和术前JOA评分被确定为住院时间延长的独立危险因素(P<0.05)。

结论

基于快速康复理念的营养支持模式已被发现对接受MIS-TLIF的退变性腰椎管狭窄症患者有诸多益处。这些益处包括缩短住院时间、降低治疗费用和减少下床活动时间。此外,逻辑回归分析确定了几个可影响住院时间长短的独立危险因素。这些危险因素包括年龄、糖尿病史、护理方案、手术时间和术前JOA评分。

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