【摘要】 目的 探討經皮脊柱后凸成形手術中骨水泥的應用療效。 方法 2008年10月-2010年10月，應用注射用Ⅲ型丙烯酸樹脂骨水泥及其椎體成形系統，采取經皮脊柱后凸成形術治療40例椎體疾病患者。其中男5例，女35例；年齡53～84歲，平均65歲。老年骨質疏松性椎體壓縮骨折37例，椎體惡性腫瘤2例，椎體血管瘤1例。采用視覺模擬評分（visual analogue scale，VAS）對患者手術前后疼痛程度的改善情況進行評分統計，并觀察術中及術后并發癥的發生情況。 結果 患者出院前行脊柱正、側位透視，發現椎體內骨水泥分布良好；3例有少量骨水泥向椎體外滲漏現象，但均無臨床癥狀。所有患者獲隨訪1～12個月，平均8個月。腰背部疼痛均明顯緩解或消失，日常生活質量大大提高。術前VAS評分為（8.30±0.48）分，術后3 d、1個月及末次隨訪時VAS評分分別為（3.11±0.41）、（2.50±0.36）、（2.50±0.36）分，與術前比較差異均有統計學意義（Plt;0.05）。 結論 骨水泥應用于經皮脊柱后凸成形手術中可取得很好療效，固化的骨水泥對脊柱起到很好的支撐、穩定作用。【Abstract】 Objective To assess the clinical effect of using bone cement in percutaneous kyphoplasty. Methods From October 2008 to October 2010, type Ⅲ Acrylic resin bone cement and the system of vertebroplasty were used in percutaneous kyphoplasty (PKP) to treat 40 patients. There were 5 males and 35 females with an average of 65 years old (53-84 years). There were 37 older patients with osteoporotic vertebral compression fracture, 2 cases of vertebral tumor and one hemangioma. Visual analogue scale (VAS) was used to evaluate the pain before and after the operation. The complications in and after the operation were also recorded. Results Before discharge, posterior-anterior and lateral X-ray films were taken to evaluate the distribution of bone cement. Three patients showed a little bone cement leakage from the vertebral body, but no clinical symptoms were found. All patients were followed for 1 to 12 months with an average of 8 months. Pain in the back decreased obviously or disappeared, and the qualities of daily life were improved greatly. The score of VAS was (8.30±0.48) before the operation, and (3.11±0.41), (2.50±0.36), and (2.50±0.36) 3 days, 1 month after the operation, and during the last follow-up, respectively. Significant differences were found between the VAS score before and after operation (Plt;0.05). Conclusions Good results can be expected when bone cement is used in percutaneous kyphoplasty. Solidified bone cement can effectively support and stablize the spinal column.
【摘要】 探討日間手術模式的運行流程及效果，并對日間手術的管理及優勢予以總結。2009年10月-2011年2月，我中心采用日間手術模式對普外、兒外、泌尿、耳鼻喉、眼、消化、腎臟等疾病患者施行手術治療。順利完成日間手術約5 900余例，日間手術成功率100%，未發生1例因為遲發并發癥而重新入院治療事件，患者及家屬對各自的治療方案滿意。合理的日間手術模式和流程，可以最大限度地減少醫療費用，縮短患者等待入院和行手術時間，提高床位周轉率和利用率，符合醫患雙方的利益。【Abstract】 This article discusses the operating process and results of ambulatory surgery, and to summarize the management and advantages of ambulatory surgery. From October 2009 to February 2011, the mode of ambulatory surgery was used in our department to treat patients. General, pediatric, urological, otolaryngological, ophthalmological surgeries and surgeries for digestive system and kidney were completed in this mode. About 5 900 surgeries were completed successfully with a mission success rate of 100%. No rehospitalization event occurred because of late onset complications. Both patients and families were satisfied with the treatment. Reasonable mode and process of ambulatory surgery can decrease cost of the patients, shorten waiting time of being admitted and operated, and improve the turnover and using rates of beds. It will bring benefits for both hospitals and patients.
