反Trendelenburg体位对强直性脊柱炎后路截骨矫形手术中唤醒试验的影响

发布时间：2019-06-09 22:40

【摘要】：目的观察反Trendelenburg体位对强直性脊柱炎(ankylosing spondylitis,AS)胸腰椎后凸畸形患者经椎弓根椎体截骨(pedicle subtraction osteotomy,PSO)术中唤醒试验的影响。方法选择行PSO术的AS胸腰椎后凸畸形患者28例,年龄20~50岁,均为男性,随机分为Trendelenburg组(抬高组)13例,不抬高组(水平组)15例。两组患者麻醉方式、麻醉诱导和维持用药均相同,比较抬高组和水平组患者PSO术中唤醒时间及唤醒质量。结果所有患者术中唤醒试验均成功。抬高组患者的术中唤醒时间为(25.8±5.8)min,明显短于水平组的(39.6±9.7)min(P0.05)。抬高组唤醒质量较水平组高,抬高组患者术后颜面部及球结膜水肿的外观表现较水平组轻。结论 AS胸腰椎后凸畸形患者PSO术中头部抬高体位可以缩短术中唤醒时间、提高患者的唤醒质量。
[Abstract]:Objective to observe the effect of anti-Trendelenburg position on wake-up test in patients with ankylosing spondylitis (ankylosing spondylitis,AS) thoracolumbar kyphosis via pedicle osteotomy (pedicle subtraction osteotomy,PSO). Methods 28 patients with AS thoracolumbar kyphosis underwent PSO operation, all of them were male. They were randomly divided into Trendelenburg group (n = 13) and non-elevation group (n = 15). The anaesthesia mode, induction and maintenance of anesthesia were the same in the two groups. The awakening time and arousal quality of the patients in the elevation group and the level group were compared. Results all the patients were successfully awakened during operation. The intraoperative arousal time of the patients in the elevation group was (25.8 卤5.8) min, which was significantly shorter than that in the horizontal group (39.6 卤9.7) min (/ P 0.05). The arousal quality of the elevation group was higher than that of the level group, and the appearance of facial and bulbar conjunctival edema in the elevation group was lighter than that in the level group. Conclusion head elevation posture in AS patients with thoracolumbar kyphosis can shorten the wake-up time and improve the arousal quality of patients with thoracolumbar kyphosis.
【作者单位】：南京大学医学院附属鼓楼医院麻醉科;南京大学医学院附属鼓楼医院骨科;
【分类号】：R687.3

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