体温冲洗液在经皮经椎间孔内镜椎间盘切除术中的有效性和安全性：一项前瞻性研究。

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-06-25 DOI:10.1016/j.wneu.2025.124206

He Zhu , Liang Zheng , Shuang Wang , Jia-qi Zhang , Yu Chen

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引用次数: 0

摘要

研究设计：前瞻性研究目的：探讨经皮经椎间孔内镜椎间盘切除术（PTED）中体温冲洗液对患者的影响。方法：选取2024年1 - 10月在我院骨科行PTED手术的患者为研究对象。根据纳入标准和排除标准对患者进行筛选，符合标准的患者随机分为实验组和对照组。对照组术中使用室温冲洗液，实验组术中使用体温冲洗液。分析两组患者术后炎症等指标的差异。采用视觉模拟量表（VAS）评分，比较患者术后不同时间点腰痛的严重程度。在手术过程中，持续监测体温变化。并比较术中、术后体温和室温灌洗液引起的并发症发生率。结果：筛选后共入组71例患者。随机分为实验组（n=34）和对照组（n=37）。实验组30例患者完成随访，对照组32例患者完成随访。两组患者一般临床资料差异无统计学意义，具有可比性（P < 0.05）。两组患者术后1 d血清c反应蛋白（CRP）、白细胞介素-6 （IL-6）、血清淀粉样蛋白a （SAA）水平差异均有统计学意义（P < 0.05），且实验组低于对照组。实验组腰痛VAS评分至术后1 d均显著低于对照组，差异有统计学意义（P < 0.05）。两组体温均逐渐下降。手术60 min后，在后续多个时间点，实验组体温均高于对照组，差异有统计学意义（P < 0.05）。两组患者术中、术后1天、术后1个月并发症发生率比较，差异均无统计学意义（P < 0.05）。结论：在PTED中，使用体温冲洗液不仅具有与室温冲洗液相同的安全性，而且具有更好的临床效果。

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Effectiveness and Safety of Body-Temperature Irrigation Fluid in Percutaneous Transforaminal Endoscopic Discectomy: A Prospective Study

Objective

Investigation into the effect of body-temperature irrigation fluid during percutaneous transforaminal endoscopic discectomy (PTED) on patients.

Methods

Patients undergoing PTED at the Orthopedic Department of our hospital from January to October 2024 were selected as study subjects. Patients were screened according to the inclusion and exclusion criteria, and those meeting the criteria were randomly allocated to the experimental group or the control group. The control group used room-temperature irrigation fluid during surgery, whereas the experimental group used body-temperature irrigation fluid. The differences in postoperative inflammatory and other parameters between the 2 groups were analyzed. The visual analog scale scores were evaluated to compare the severity of low back pain at different postoperative time points among patients. During the surgical procedure, the body temperature changes were continuously monitored. In addition, the complication rates caused by body-temperature and room-temperature irrigation fluid were compared during and after surgery.

Results

A total of 71 patients were enrolled after screening. They were randomly allocated to the experimental group (n = 34) and the control group (n = 37). In the experimental group, 30 patients completed follow-up, and 32 patients completed follow-up in the control group. The general clinical data of the 2 groups showed no statistically significant differences, indicating comparability (P > 0.05). The levels of C-reactive protein, interleukin-6, and serum amyloid A were significantly different between the 2 groups at 1 day postoperatively (P < 0.05), with the experimental group having lower values than the control group. The visual analog scale scores of low back pain in the experimental group were significantly lower than those in the control group until 1 day postoperatively, with statistically significant differences (P < 0.05). The body temperatures of both groups gradually declined. After 60 minutes of surgery, at multiple subsequent time points, the experimental group exhibited higher body temperatures than the control group, demonstrating statistically significant differences (P < 0.05). There was no statistically significant difference in the incidence of complications between the 2 groups during surgery, at 1 day postoperatively, and at 1 month postoperatively (P > 0.05).

Conclusions

In PTED, the use of body-temperature irrigation fluid not only provides the same safety profile as room-temperature irrigation fluid but also achieves better clinical outcomes.

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS