"透析依赖患者的腰椎退行性手术:并发症和患者报告的结果"
Yuki Ishikawa1, Hideki Nakamoto2, So Kato2
1Department of Spine and Orthopedic Surgery, Japanese Red Cross Medical Center, 4-1-22, Hiroo, Shibuya-Ku, Tokyo, 150-8935, Japan.
概括
经过腰椎手术的透析依赖患者在患者报告的结果 (PROM) 和满意度方面表现出显著的,不劣质的改善. 尽管并发症风险较高,但手术对于某些患者来说是一个可行的选择.
科学领域:
- 神经外科 神经外科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 整形外科手术 整形外科手术
背景情况:
- 透析患者的腰椎手术结果没有得到充分的记录,尤其是在患者报告的结果测量 (PROM) 中.
- 透析患者经常出现更多的并发症和较差的基线健康状况,这可能会影响外科手术的结果.
研究的目的:
- 评估患者报告的结果指标 (PROM) 和在接受选择性腰部退行性手术的透析依赖患者的并发症率.
- 为了比较透析依赖和非透析依赖患者队列之间的手术结果.
主要方法:
- 一项多中心的回顾性队列研究分析了19,911名患者 (361名透析依赖者,19,550名非透析依赖者) 接受选择性腰部退行性手术.
- 评估的结果包括1年的疼痛变化 (数值评分表),生活质量 (EuroQol5维),残疾 (Oswestry残疾指数),患者满意度以及30天的术后并发症和重复手术.
- 倾向性得分匹配用于比较群体之间的结果,用于PROMs的非劣势测试.
主要成果:
- 透析依赖的患者年龄较大,美国麻醉师协会身体状况 (ASA-PS) 评分较高,并发症较多,并发症和重新手术率更高.
- 尽管基线PROMs较差,但PROMs (疼痛数值评分表,EuroQol5维,奥斯威斯特残疾指数) 的改善在透析依赖患者中与匹配队列中的非透析依赖患者相比,并非较差.
- 在依赖透析的组中,患者满意度较低 (74%对83%),但仍然很大,在两组中都观察到PROM的显著术后改善.
结论:
- 腰椎手术可以导致PROM的显著和非劣质改善,以及对透析依赖患者的满意度.
- 尽管基线挑战和风险增加,腰椎手术对于精心挑选的透析依赖者来说是一个可行的治疗选择.
- 进一步的研究应该专注于优化手术选择和术后管理这群患者.
关键词:
欧洲高质量五维 (EQ-5D)数字评级表 (NRS) 是一个数字评级表.奥斯韦斯特里残疾人指数 (ODI)退行性腰部疾病 退行性腰部疾病需要透析的病人需要透析.腰椎脊椎手术 腰椎脊椎手术患者报告的结果措施 (PROMs)术后并发症 术后并发症更多相关视频
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