手术治疗高龄脊髓型颈椎病患者的临床疗效

发布时间：2018-12-11 23:54

【摘要】：目的探讨高龄对脊髓型颈椎病(CSM)患者手术治疗临床效果的影响。方法随访统计113例CSM患者,其中96例完成随访,采用不同的前路(84例)及后路手术(12例)治疗,分高、低龄两组,高龄组,男16例,女36例;低龄组,男14例,女30例;应用日本骨科协会(JOA)评分系统进行疗效评价,比较两组术后疗效及并发症情况。结果高、低年龄组在身高、体重、性别、住院天数、手术时间方面差异无统计学意义(P0.05),而术中出血量有差异(P0.05);高、低龄组术后终末随访JOA评分改善率分别为(55.14±21.40)%,(62.63±21.69)%,优良率分别为67.3%,63.6%,两组差异均无统计学意义(P0.05);手术治疗后随访期间改善率恢复达到50%以上的累计生存率差异无统计学意义(χ~2=1.438,P=0.23)。结论高龄患者术中出血风险较低龄略高,术后神经功能恢复情况无差异,手术并不对高龄CSM患者造成威胁,低风险的高龄患者可获得与低龄组患者类似的治疗效果。
[Abstract]:Objective to investigate the effect of old age on surgical treatment of cervical Spondylotic myelopathy (CSM). Methods A total of 113 cases of CSM were followed up, 96 of them were followed up and treated with different anterior approach (84 cases) and posterior approach (12 cases). They were divided into two groups: high and low age group, aged group (16 cases, male 16, female 36 cases), low age group (14 cases, male 14, female 30 cases), low age group (14 cases, female 30 cases). The (JOA) scoring system of Japan Orthopaedics Association was used to evaluate the efficacy and complications of the two groups. Results there was no significant difference in height, weight, sex, length of hospitalization and operation time between the high and low age groups (P0.05), but there was significant difference in the amount of intraoperative bleeding (P0.05). The improvement rate of JOA score was (55.14 卤21.40)%, (62.63 卤21.69)%, and the excellent and good rate was 67.3% and 63.6%, respectively. There was no significant difference between the two groups (P0.05). There was no significant difference in the cumulative survival rate (蠂 ~ 2 ~ 2 ~ 1.438P ~ (0.23) when the improvement rate was more than 50% during the follow-up period after operation. Conclusion the risk of intraoperative hemorrhage in the elderly patients is slightly higher than that in the younger age, and there is no difference in the recovery of neurological function after operation. The operation does not pose a threat to the elderly patients with CSM. The low-risk elderly patients can obtain similar therapeutic effects as those in the younger age group.
【作者单位】：天津医科大学第一中心临床学院;天津市第一中心医院;承德医学院附属医院;
【分类号】：R687.3

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