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在脊椎外科手术中进行预康复的综合指南

Paulomi Gohel¹, Raj Swaroop Lavadi¹, Mohamed-Ali H Jawad-Makki¹

¹Department of Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Journal of craniovertebral junction & spine

|April 28, 2025

概括

通过预康复优化选择性脊柱手术结果. 关键干预措施包括戒烟,减肥,运动,戒酒,营养支持,阿片类药物断奶和认知行为疗法,以改善患者的康复.

科学领域:

脊柱外科手术脊柱外科手术
康复前医学康复前医学
基于证据的实践.

背景情况:

选择性脊柱手术患者经常面临重大的术后并发症.
预康复策略旨在通过在手术前优化患者健康来减轻这些风险.

研究的目的:

系统地审查和综合选择性脊柱手术的预康复技术.
制定一个全面的基于证据的预康复建议清单.

主要方法:

按照PRISMA指南进行系统的文献审查.
在三个数据库中 (1997-2021) 搜索了关于脊柱外科手术前康复的研究.
分析了70项选定的研究,将研究结果与作者临床实践相结合.

主要成果:

推手术前戒烟 (3-4周前).
建议用于减肥计划 (BMI <35 kg/m2),为了心肺健康而运动,以及戒酒.
建议维生素D,和副甲状腺激素治疗骨质疏松症;阿片类药物断奶 (6-8周前);以及精神伴随性疾病的认知行为疗法 (CBT).

结论:

对于接受选择性脊柱手术的患者来说,全面的预康复方案至关重要.
针对患者风险因素的个性化干预措施显著改善了手术后的结果.

关键词:

选择性脊柱手术是可以选择的.术后并发症术后并发症康复前期治疗是什么术前的风险术前的风险

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