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皮质类固醇对前椎切除和前椎融合上消化管上部功能的影响:使用高分辨率阻抗测量仪的研究
Chih-Jun Lai1,2, Jo-Yu Chen3,4, Jing-Rong Jhuang5
1Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.
The Journal of bone and joint surgery. American volume
|October 23, 2024
概括
局部皮质类固醇可以降低前椎切除和融合 (ACDF) 手术后的上食道 (UES) 放松压力. 这一发现通过高分辨率阻抗计量 (HRIM) 进行评估,表明吞功能的潜在益处.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 神经外科 神经外科
- 胃肠病学 胃肠病学
背景情况:
- 在前椎间盘切除和融合 (ACDF) 之后,缺是常见的担忧.
- 有限的研究存在于局部皮质类固醇在缓解ACDF后的疗效.
- 高分辨率阻抗计 (HRIM) 和EAT-10是评估吞功能的关键工具.
研究的目的:
- 为了研究局部皮质类固醇在ACDF后对吞功能的影响.
- 用HRIM评估对食道上 (UES) 放松和喉收缩的影响.
- 用 EAT-10 问卷来评估患者报告的吞困难.
主要方法:
- 一个随机对照试验,比较局部氨 (皮质类固醇组) 与盐溶液 (对照组) 进行了前脊椎注射.
- 接受ACDF的患者在术前和术后1个月被评估.
- 测量了HRIM参数 (UES放松,开放,腹内压力,喉收缩) 和EAT-10分数.
主要成果:
- 在手术前UES放松压力中,两组之间没有显著差异.
- 在手术后,皮质类固醇组的UES放松压力中位数 (24.5 mm Hg) 与盐酸组 (33.6 mm Hg; p=0.01) 相比显著降低.
- 所有其他HRIM参数和EAT-10得分在各组之间都相似;没有报告任何不良事件.
结论:
- 局部皮质类固醇可能会降低UES放松压力一个月后ACDF.
- 这种降低UES放松压力可能会改善UES打开和吞.
- 需要进一步的研究来证实这些发现及其临床影响.
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