前纵韧带—颈长肌复合体重建对颈前路减压融合术后吞咽功能影响的临床研究
发布时间：2019-04-16 13:54
【摘要】：目的对比观察颈前路减压融合术中重建前纵韧带-颈长肌复合体对患者术后早期吞咽功能的影响,并进一步探讨影响术后吞咽功能的相关因素。方法选择2012年10-2014年10月我科收治的单节段或邻近双节段病变的颈椎病患者316例,其中术后能够得到完整随访的患者共有241例。根据术中对颈长肌及前纵韧带处理方式不同将241例颈椎病患者分为缝合组(A组,129例)和不缝合组(B组,112例),然后依据手术节段将样本分为单节段缝合组(A1,72例)、连续双节段缝合组(A2,57例)、单节段未缝合组(B1,62例)和连续双节段未缝合组(B2,50例)。通过对比分析各组患者在术后第2天、术后1周、1个月、3个月及6个月随访时的吞咽困难发生率、吞咽-生活质量(Swallowing Quality Of Life, SWAL-QOL)评分及椎前软组织平均厚度的变化情况。结果术后第2天、术后1周、1个月随访时,A1组患者的吞咽困难发生率均分别低于B1组和A2组(p0.05),Al组患者的SWAL-QOL评分均分别高于Bl、A2两组(p0.05),而B2组患者的吞咽困难发生率均分别高于B1、A2两组(p0.05),B2组患者的SWAL-QOL评分均分别低于Bl、A2两组(p0.05)。术后3、6个月随访时,各组患者的吞咽困难发生率及SWAL-QOL评分在组间进行两两比较后均无统计学差异(p0.05)。在手术前后各次随访时各组间患者的椎前软组织平均厚度变化比较均无统计学差异(p0.05)。结论颈前路减压、植骨融合内固定术中重建前纵韧带-颈长肌复合体能够有效的减少术后早期吞咽困难发生率,且相邻双节段手术患者术后吞咽困难发生率高于单节段患者。
[Abstract]:Objective to observe the effect of anterior longitudinal ligament-longissimus complex reconstruction in anterior cervical decompression and fusion on the early swallowing function of patients after operation, and to further explore the related factors affecting postoperative swallowing function. Methods from October 2012 to October 2014, 316 patients with cervical spondylosis with single or adjacent double segment lesions were enrolled in our department. Totally 241 patients were able to be followed up completely after operation. 241 cases of cervical spondylosis were divided into suture group (group A, 129 cases) and non-suture group (group B, 112 cases) according to the different management methods of the longus cervicalis and anterior longitudinal ligament during operation, and then the samples were divided into single segment suture group (A1, 72 cases) according to the operative segment. Continuous double segment suture group (A 2, 57 cases), single segment unsutured group (B 1, 62 cases) and continuous double segment suture group (B 2, 50 cases). The incidence of dysphagia, swallowing-quality of life (Swallowing Quality Of Life,) during follow-up of 2 days, 1 week, 1 month, 3 months and 6 months after operation in each group were compared and analyzed. SWAL-QOL score and the change of average thickness of prevertebral soft tissue. Results at 2 days, 1 week and 1 month follow-up, the incidence of dysphagia in A1 group was lower than that in B1 group and A2 group, respectively. The SWAL-QOL scores in p0.05), Al group were higher than those in Bl,A2 group (p0.05), and the incidence of dysphagia in A1 group was higher than that in Bl,A2 group (p0.05). The incidence of dysphagia in group B2 was higher than that in group B1, the scores of SWAL-QOL in group A2 (p0.05) and group B2 were lower than those in group Bl,A2 (p0.05). There was no significant difference in the incidence of dysphagia and SWAL-QOL score between groups 3 and 6 months after operation (p0.05). There was no significant difference in the mean thickness of prevertebral soft tissue between groups before and after operation (p0.05). Conclusion anterior cervical decompression and internal fixation with bone graft fusion can effectively reduce the incidence of dysphagia in early postoperative patients, and the incidence of dysphagia in adjacent bi-segmental surgery is higher than that in single segment.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
本文编号：2458832
[Abstract]:Objective to observe the effect of anterior longitudinal ligament-longissimus complex reconstruction in anterior cervical decompression and fusion on the early swallowing function of patients after operation, and to further explore the related factors affecting postoperative swallowing function. Methods from October 2012 to October 2014, 316 patients with cervical spondylosis with single or adjacent double segment lesions were enrolled in our department. Totally 241 patients were able to be followed up completely after operation. 241 cases of cervical spondylosis were divided into suture group (group A, 129 cases) and non-suture group (group B, 112 cases) according to the different management methods of the longus cervicalis and anterior longitudinal ligament during operation, and then the samples were divided into single segment suture group (A1, 72 cases) according to the operative segment. Continuous double segment suture group (A 2, 57 cases), single segment unsutured group (B 1, 62 cases) and continuous double segment suture group (B 2, 50 cases). The incidence of dysphagia, swallowing-quality of life (Swallowing Quality Of Life,) during follow-up of 2 days, 1 week, 1 month, 3 months and 6 months after operation in each group were compared and analyzed. SWAL-QOL score and the change of average thickness of prevertebral soft tissue. Results at 2 days, 1 week and 1 month follow-up, the incidence of dysphagia in A1 group was lower than that in B1 group and A2 group, respectively. The SWAL-QOL scores in p0.05), Al group were higher than those in Bl,A2 group (p0.05), and the incidence of dysphagia in A1 group was higher than that in Bl,A2 group (p0.05). The incidence of dysphagia in group B2 was higher than that in group B1, the scores of SWAL-QOL in group A2 (p0.05) and group B2 were lower than those in group Bl,A2 (p0.05). There was no significant difference in the incidence of dysphagia and SWAL-QOL score between groups 3 and 6 months after operation (p0.05). There was no significant difference in the mean thickness of prevertebral soft tissue between groups before and after operation (p0.05). Conclusion anterior cervical decompression and internal fixation with bone graft fusion can effectively reduce the incidence of dysphagia in early postoperative patients, and the incidence of dysphagia in adjacent bi-segmental surgery is higher than that in single segment.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
【参考文献】
相关期刊论文 前1条
1 陈雄生,贾连顺,曹师锋,袁文,陈德玉,叶晓健,周许辉,谭军,肖建如,倪斌,欧阳跃平;颈椎前路手术的并发症[J];中华骨科杂志;2003年11期
，本文编号：2458832
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