Application Of The Concept Of Rapid Rehabilitation Surgery In Lumbar PVP And PTED Perioperative Period

Objective: To observe the efficacy of TCM rapid rehabilitation surgery in lumbar minimally invasive surgery,and to provide theoretical basis and data support for its extensive use in clinical practice.Methods: selected from Guangxi ruikang affiliated university of Chinese medicine hospital national administration of Chinese medicine spinal surgery two wards will do lumbar minimally invasive surgery patients a total of 120 patients,including single osteoporosis compression fracture patients need percutaneous vertebroplasty(PVP),due to single segment lumbar disc herniation percutaneous endoscopic lumbar disc removal(PTED)patients 60 cases,two groups according to the random number method randomly divided into observation group and control group,30 cases of each group.For the observation group using rapid rehabilitation surgery perioperative management,control group using conventional rehabilitation surgery perioperative management,record general data of two groups,surgery related pain score(VAS,ODI),inflammation and stress,white cell count,C-reaction protein),postoperative recovery(time,hospital time),patient satisfaction,through the collection,statistics and analysis of data,evaluate the difference between the two groups,a preliminary conclusion.Results: 1.In the course of the trial,one case was excluded from PVP observation group,and one case from control group fell off,and 118 cases were completed,with no adverse events or complications.2.There was no statistically significant difference between the PVP and PETD groups for their respective sex,age,disease duration,and lesion segments(P> 0.05),and the general data before the operation were comparable.3.Results of VAS and ODI before and after surgery: The preoperative VAS and ODI scores of PVP and PTED observation group and control group were significantly different from those of the first day,one week and one month after surgery,as well as each time period after surgery compared with the previous time period(P < 0.05).However,VAS and ODI scores of PVP and PTED observation group and control group showed no difference before surgery and day 1 after surgery.VAS and ODI scores of PVP and PTED observation group and control group showed a downward trend at the 1st week and 1st month after surgery,and with the extension of time,VAS and ODI scores of the observation group decreased more than that of the control group,and at the 1st week and 1st month after surgery,VAS and ODI scores of the PVP observation group were significantly compared with those of the control group.The difference was statistically significant(P < 0.05),and the analgesic effect was obvious.4.Results of inflammation and stress indicators: There were no significant differences in preoperative white blood cell count(WBC),ESR and C-reactive protein(CRP)between the PVP observation group and the control group(P > 0.05),indicating comparability.There were no significant differences in preoperative and postoperative WBC between the two groups(P > 0.05).There were differences in ESR and CRP between the observation group and the control group before and after operation(P < 0.05),and there were differences in ESR and CRP between the observation group and the control group after operation(P < 0.05),indicating that the observation group was more effective in reducing inflammatory response.There were no significant differences in WBC,ESR and CRP between the PTED observation group and the control group before and after surgery(P > 0.05).5.Postoperative recovery(underground time,length of hospital stay)and satisfaction results: There was no statistical significance in underground time between the observation group and the control group(P > 0.05),and the observation group was superior to the control group in terms of length of hospital stay and satisfaction(P < 0.05).6.Conclusion: rapid rehabilitation of traditional Chinese medicine surgery in lumbar minimally invasive surgery perioperative effect is better,to a certain extent can relieve patients with pain symptoms and restore daily life function as soon as possible,reduce some inflammation and stress index,promote postoperative recovery,shorten hospital stay,at the same time can improve the satisfaction of patients,is worth application in clinical practice.