第一次单层腰部微分隔切除术后长时间停留的危险因素
Leonard Ritter1, Adrian Liebert2, Thomas Eibl2
1Department of Neurosurgery, Paracelsus Medical University, Breslauer Str. 201, 90471, Nuremberg, Bavaria, Germany. leonard.ritter@klinikum-nuernberg.de.
Acta neurochirurgica
|February 13, 2024
概括
手术前的不动性是腰部微分隔切除术后长时间住院的关键预测因素. 在外科手术前识别行动能力有限的患者可以帮助管理延长康复的期望和资源.
科学领域:
- 神经外科 神经外科
- 整形外科 整形外科 整形外科
- 医学经济学 医学经济学
背景情况:
- 腰椎微切除术是治疗椎间盘的常见手术.
- 优化患者康复和医院资源分配需要了解影响住院时间 (LOS) 的因素.
研究的目的:
- 为了确定第一个单一水平开放的腰部微分切除术后与长时间住院相关的风险因素.
- 确定延长术后住院治疗的独立预测因素.
主要方法:
- 对200名接受首次单一水平开放性腰部微分切除术的患者进行了回顾性分析.
- 收集的数据包括人口统计,病史,手术内细节和术后麻醉剂消费.
- 使用双变量和多步回归分析来确定影响LOS的因素,长时间的LOS被定义为超过中位停留时间.
主要成果:
- 在双变体分析中,最初有7个因素与长时间的LOS有关,包括性别,年龄,手术前不运动,糖尿病,抗凝血/抗血小板使用,术后麻醉剂消费和核切除.
- 多变量回归分析确定了手术前的不移性是术后长期住院的唯一独立预测因素.
- 手术前不运动的患者在医院住院时间的中位数明显更长 (5天与4天相比).
结论:
- 手术前的不动性是腰部微分隔切除术后长时间住院的重要预测因素.
- 在手术前评估患者的流动性对于识别患有延长住院风险的人来说至关重要.
- 需要进一步的前性研究来验证这些发现,并探索移动性分级系统.
相关概念视频
01:29Herniated Intervertebral Disc l: Introduction
31
Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
31
01:27Degenerative Disc Disease I: Introduction
23
Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...
23
01:23Degenerative Disc Disease ll: Pathophysiology
21
The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...
21