摘要
目的:评估颈前路人工椎间盘置换术(anterior artificial disc insertion,AADI)和颈前路椎间减压融合术(anterior cervical discectomy and fusion,ACDF)两种不同术式对术后早期吞咽功能的影响。方法:回顾性分析2010年1月-2011年4月收治的98例接受单节段或双节段神经根型/脊髓型颈椎病患者。按治疗方法分为两组,A组53例,采用AADI术式,B组45例,采用ACDF术式。对比两组患者术后48h、2个月及6个月时吞咽困难发生率、吞咽生活质量(Swallowing-Quality of Life,SWAL-QOL)评分及椎前软组织厚度的改变,比较两种术式吞咽困难并发症的发生情况。结果:A组患者手术时间(85.66±11.84min)明显低于B组(93.78±14.81min)(P<0.05)。在术后48h及术后2个月随访时,A组患者吞咽困难发生率(30.19%,3.77%)和椎前软组织厚度(10.99±1.66mm,10.17±1.87mm)明显低于B组患者(分别为51.11%,15.56%,11.92±1.59mm,11.45±1.59mm)(P<0.05)。术后48h和2个月时,A组患者SWAL-QOL评分(59.20±7.23,63.77±3.37)明显高于B组(53.91±8.99,62.07±4.51)(P<0.05)。术后6个月随访时,两组间各指标无统计学差异。结论:相对于ACDF,AADI手术时间较短,手术过程及置入物对食道的损伤和刺激较小,术后吞咽困难发生率和吞咽困难的严重程度较低。
Objectives： To evaluate the influence of anterior artificial disc insertion（AADI） and anterior cervi- cal discectomy and fusion（ACDF） on postoperative dysphagia. Methods： 98 patients undergoing one-level and two-level AADI and ACDF were retrospectively reviewed in this study. There were 53 patients in group A who underwent AADI and 45 patients in group B who underwent ACDF. The operation time and blood loss were recorded. The dysphagia rate, Swallowing-Quality of Life（SWAL-QOL） score and the thickness of prever- tebral soft tissue at each follow-up were compared. Results： The operation time was significantly lower in group A（85.66±11.84min） than that of group B（93.78±14.81min）（P〈0.05）. The dysphagia rate and thickness of prevertebral soft tissue thickness were significantly lower in group A at 48 hours and 2 months postoperative- ly（30.19%, 3.77%, 10.99±1.66mm, 10.17±1.87mm） than that of group B（51.11%, 15.56%, 11.92±1.59mm, 11.45±1.59mm）（P〈0.05）. The SWAL-QOL score of group A（59.20±7.23, 63.77±3.37） was significantly higher at 48 hours and 2 months postoperatively than that of group B（53.91±8.99, 62.07±4.51）（P〈0.05）. No significant difference between groups were observed at 6 month follow-up. Conclusions： AADI is associated with a less operation time, a less irritation to prevertebral soft tissue and a lower dysphagia rate at the first several months postoperatively.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
北大核心
2013年第1期25-29,共5页
Chinese Journal of Spine and Spinal Cord
作者简介
男（1987-），硕士研究生，研究方向：脊柱外科电话：（021）86886806E-mail：guyifei0001@126．com通讯作者：袁文E-mail：yuanwen_spine@126．com
杨立利E-mail：orthoyang@sina．com
