颈椎后纵韧带骨化症经前路减压植骨融合术的麻醉处理

目的通过对比颈椎后纵韧带骨化症(ossification of posterior longitudinal ligament,OPLL)与非OPLL颈椎病经前路减压融合手术平均在每个节段所花的手术时间、出血量和输血量上的差异性,为完善麻醉方案提供参考依据。方法选择我院2007年1月—2008年12月的OPLL经前路减压融合手术患者17例和随机抽取30例非OPLL颈椎病(剔除肿瘤和外伤患者)经前路手术患者,分析平均在每个节段所花的手术时间、出血量和输血量上的差异性。结果OPLL比非OPLL颈椎病患者前路减压融合术平均在每个节段所花的手术时间明显要长(P<0.01)、出血量显著增加(P<0.01)。OPLL患者大部分需要输血,平均输血量约为850 ml,非OPLL患者基本不用输血。结论OPLL经前路手术所需时间比非OPLL颈椎病前路手术要长,出血量明显增加,大部分患者需要输血。因此,麻醉方案中应包括有创动脉血压监测、尿量监测和深静脉穿刺置管,多节段OPLL者术前必需充足备血。

Anesthetic Management of Cervical Ossification of Posterior Longitudinal Ligament by Anterior Decompression and Fusion Surgery

Objective To provide reference for improving the anesthesia program by comparing cervical ossification of posterior longitudinal ligament with non-OPLL of cervical spondylopathy by anterior decompression and fusion surgery in each segment in the factors as operation time,bleeding volume and transfusion of blood volume on the differences.Methods 17 patients suffering OPLL and thirty patients of non-OPLL cervical spondylopathy were selected(with randomly selected,excluding tumor and trauma patients) by Anterior decompression and fusion surgery during 2007 and 2008 in Changzheng Hospital,and to analyze their average in each segment of the flower of operation time,bleeding volume and transfusion of blood volume on the differences.Results It spent significantly longer operative time on average in each segment than non-OPLL patients with anteri or cervical decompression and fusion surgery(P<0.01).The hemorrhage volume of OPLL increased significantly than non-OPLL patients on average in each segment(P<0.01).Most of OPLL patients required blood transfusion,the average volume of blood transfusion was 850ml.Most do not have a blood transfusion in patients with non-OPLL.Conclusion The operation time of OPLL patients was longer than non-OPLL patient's,its hemorrhage volume was more than the non-OPLL patient's,and most patients needed blood transfusion.Therefore,anesthesia measures should included invasive arterial blood pressure monitoring,urine monitoring and deep-vein catheterization,adequate preoperative preparation of blood in multi-segmental of OPLL patients.