【摘要】 目的 探讨经皮脊柱后凸成形手术中骨水泥的应用疗效。 方法 2008年10月-2010年10月，应用注射用Ⅲ型丙烯酸树脂骨水泥及其椎体成形系统，采取经皮脊柱后凸成形术治疗40例椎体疾病患者。其中男5例，女35例；年龄53～84岁，平均65岁。老年骨质疏松性椎体压缩骨折37例，椎体恶性肿瘤2例，椎体血管瘤1例。采用视觉模拟评分（visual analogue scale，VAS）对患者手术前后疼痛程度的改善情况进行评分统计，并观察术中及术后并发症的发生情况。 结果 患者出院前行脊柱正、侧位透视，发现椎体内骨水泥分布良好；3例有少量骨水泥向椎体外渗漏现象，但均无临床症状。所有患者获随访1～12个月，平均8个月。腰背部疼痛均明显缓解或消失，日常生活质量大大提高。术前VAS评分为（8.30±0.48）分，术后3 d、1个月及末次随访时VAS评分分别为（3.11±0.41）、（2.50±0.36）、（2.50±0.36）分，与术前比较差异均有统计学意义（Plt;0.05）。 结论 骨水泥应用于经皮脊柱后凸成形手术中可取得很好疗效，固化的骨水泥对脊柱起到很好的支撑、稳定作用。【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】 探讨日间手术模式的运行流程及效果，并对日间手术的管理及优势予以总结。2009年10月-2011年2月，我中心采用日间手术模式对普外、儿外、泌尿、耳鼻喉、眼、消化、肾脏等疾病患者施行手术治疗。顺利完成日间手术约5 900余例，日间手术成功率100%，未发生1例因为迟发并发症而重新入院治疗事件，患者及家属对各自的治疗方案满意。合理的日间手术模式和流程，可以最大限度地减少医疗费用，缩短患者等待入院和行手术时间，提高床位周转率和利用率，符合医患双方的利益。【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.