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其他题名Surgical treatment of cervical spondylotic myelopathy in aged patients
姜亮; 刘忠军; 党耕町; 蔡钦林
关键词颈椎 脊髓压迫症 脊柱融合术 椎板切除术 老年人
收录类别中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型Journal Article
摘要目的了解伴发各种全身性疾病的高龄脊髓型颈椎病患者手术治疗的可能性并分析手术疗效。方法自1993年1月~1998年10月共治疗70岁以上(70~84岁,平均72.3岁)的脊髓型颈椎病患者43例,其中有全身性伴发疾病者26例,部分患者存在一种以上伴发疾病,包括糖尿病4例、冠心病6例、高血压病12例、心律失常12例、脑血管疾患4例。43例中5例施行前路椎间盘切除植骨融合术,38例行颈椎后路椎管扩大成形术。结果手术后发生心律失常2例、应激性溃疡1例、糖尿病酮症酸中毒1例、硬膜外血肿2例、伤口延迟愈合1例、脑脊液漏2例。43例术前JOA评分2~13分,平均6.7分;术后2周JOA评分6~16分,平均11分,平均改善率42.8%。29例患者术后随访6~60个月,平均24.6个月,JOA评分7~17分,平均改善率65.2%;疗效优11例(38%)、良11例(38%)、可6例(20.6%)、差1例(3.4%)。结论对高龄脊髓型颈椎病患者,术前只要认真处理伴发疾病及并发症,一般均能平稳度过围手术期,并取得良好的手术效果。 Objective To investigate perioperative clinical features and results of surgical treatment of cervical spondylotic myelopathy (CSM) in aged patients (≥ 70 years). Methods From January 1993 to October 1998, 43 patients with CSM undergone surgery were reviewed. The average age at the time of surgery was 72.3 years (ranged from 70 to 84 years). Twenty six patients had associated conditions, i.e. diabetes mellitus in 4, coronary heart disease in 6, hypertension in 12, arrhythmia in 12, cerebral vascular disease in 4. Laminoplasty in 38 patients and anterior decompression in 5 patients were performed. Results After operation there were arrhythmia in 2 patients, stress ulcer in 1, acidosis ketosis in one case of diabetes mellitus, epidural hematoma in 2, delayed healing in 1, leakage of cerebrospinal fluid in 2. The preoperative JOA score ranged from 2 to 13 points, with an average of 6.7. Twenty nine patients were followed up for 6- 60 months, with a mean period of 24.6 months, JOA score ranged from 7 to 17 points, and in average the recovery rate was 65.2% ;11 of 29 were excellent, 11 good, 6 fair, 1 poor. Conclusion If the associated disorders and complications in aged patients with CSM are properly handled, the perioperative period will be safe. Surgical decompression for CSM appears to be a beneficial procedure even for the aged patients.
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GB/T 7714
姜亮,刘忠军,党耕町,等. 高龄脊髓型颈椎病的手术治疗[J]. 中华骨科杂志,2001,21(1):27-29.
APA 姜亮,刘忠军,党耕町,&蔡钦林.(2001).高龄脊髓型颈椎病的手术治疗.中华骨科杂志,21(1),27-29.
MLA 姜亮,et al."高龄脊髓型颈椎病的手术治疗".中华骨科杂志 21.1(2001):27-29.
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