术前脊柱注射时间对腰部减压手术术术后并发症的影响
Syed I Khalid1,2, Pranav Mirpuri3, Elie Massaad2
1Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
Neurosurgery
|February 20, 2024
概括
在腰部减压手术前外周注射类固醇 (ESI) 会增加医疗并发症和脑脊液 (CSF) 泄漏风险. 避免在手术后30天内进行ESI,以提高患者的安全性和结果.
科学领域:
- 神经外科 神经外科
- 疼痛管理 疼痛管理
- 脊柱外科手术 脊柱外科手术
背景情况:
- 外周注射类固醇注射 (ESI) 经常用于腰部疼痛.
- 腰部减压手术后ESI对结果的影响尚不清楚.
- 本研究探讨了手术前ESI和手术结果之间的关系.
研究的目的:
- 确定ESI对术后医学和手术并发症率的影响.
- 为了建立ESI和腰部减压手术之间的最佳时间间隔.
- 评估ESI时间和并发症风险之间的关联.
主要方法:
- 对587,651名经历腰椎片切除术的成年患者 (2010-2021) 的回顾性分析.
- 倾向性得分匹配在手术前90天内创建了ESI和没有ESI的队列.
- 分析了手术后30天的并发症率,特别注意注射时间.
主要成果:
- 接受ESI治疗的患者患病并发症 (4.83%对3.9%) 和脑脊液 (CSF) 泄漏率 (0.28%对0.1%) 显著增加.
- 在手术前1-30天服用ESI显示,脑脊液泄漏的几率增加了5.32倍.
- 两组之间没有观察到手术部位感染率的显著差异.
结论:
- 手术前的ESI与脊髓液泄漏和腰部减压后的医疗并发症风险增加有关.
- 建议在手术前至少30天避免ESI,以减轻这些风险.
- 这一发现有助于优化患者管理和脊柱手术手术规划.
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