Clinical Application Study Of Enhanced Recovery After Surgery Of Traditional Chinese Medicine On Perioperative Intervention Of Short-segment Posterior Approach Lumbar Fusion In Middle-aged And Elderly People

Objective: To explore the clinical efficacy of perioperative intervention for middle-aged and elderly patients with short-segment posterior approach lumbar fusion based on the concept of enhanced recovery after surgery using the traditional Chinese medicine ERAS program,and to evaluate its influence and safety on the surgical efficacy.The further clinical application and localization of the concept provide clinical reference materials and reference basis,and provide new ERAS intervention application experience for the perioperative management of short-segment lumbar fusion in spine surgery.Methods: A total of 60 middle-aged and elderly patients who were admitted to the spine and orthopaedic ward of XXX Hospital from January 2021 to January 2022 and met the inclusion criteria and planned to undergo posterior approach lumbar fusion were selected and divided into conventional ERAS group and traditional Chinese medicine group by random number table method.In the ERAS group,there were 30 cases in each group.Both groups were operated by the same surgeon.The operation method was posterior microscope combined with transforaminal lumbar fusion and internal fixation.The conventional ERAS group only followed the ERAS concept of our hospital.On the basis of these measures,the traditional Chinese medicine ERAS group combined with the traditional Chinese medicine ERAS perioperative treatment plan,including preoperative doctor-patient communication on the traditional Chinese medicine ERAS perioperative intervention plan in our hospital.Advantages are introduced,before and after the operation,the comprehensive traditional Chinese medicine intervention treatment plan such as oral administration of Buzhong Yiqi decoction,acupoint application of different traditional Chinese medicine powders,and auricular point application.The preoperative and intraoperative perioperative general data of the two groups of patients were recorded,and the relevant data were analyzed to compare the differences.The postoperative inflammatory response,postoperative complications,and postoperative lumbar function improvement of the two groups were observed.The relevant data of the two groups of patients were collected and sorted,and statistical processing was performed to analyze the changes of relevant indicators and evaluate the clinical application effect and research safety.Results: There were no significant differences in baseline data such as age,gender,BMI index,preoperative main diagnosis,fusion segment,preoperative JOA score,operation time,and intraoperative blood loss between the two groups(P>0.05),which were comparable.In terms of serum indexes observed after operation,the average C-reactive protein counts of the traditional Chinese medicine ERAS group on the 1st and 3rd days after operation were lower than those of the conventional ERAS group,and there was a statistical difference between the two groups(P<0.05).There was no significant difference in the average C-reactive protein count on the day between the two groups(P>0.05);the average white blood cell count in the traditional Chinese medicine ERAS group on the first day after surgery was lower than that in the conventional ERAS group,and the data between the two groups was statistically significant There was no significant difference in the mean white blood cell count between the two groups on the 3rd day after operation and on the day of discharge(P>0.05).In terms of postoperative complications or adverse reactions,there were no severe complications such as nerve root injury,dural rupture-cerebrospinal fluid leakage,screw loosening,surgical site infection,and lower extremity deep vein thrombosis in both groups.The number of postoperative complications such as fever,abdominal distension,constipation,nausea and vomiting were less than those in the conventional ERAS group,and the total complication rate was lower than that in the conventional ERAS group,and the difference was statistically significant(P<0.05).During intra-group comparison,the JOA scores of the two groups before and after surgery were significantly different(P<0.01).Conclusion: In the perioperative period of short-segment MIS-TLIF surgery under posterior microscope combined with tunnel for the treatment of lumbar degenerative diseases,the traditional Chinese medicine ERAS scheme based on the conventional ERAS scheme of modern medical lumbar fusion is applied.Compared with the conventional ERAS scheme It can effectively reduce the postoperative serum inflammatory factor levels in middle-aged and elderly surgical patients,stabilize the body’s stress response level after surgical trauma,and reduce the occurrence of complications caused by excessive stress of the body,without causing serious complications or adverse reactions.It has good safety and does not affect the efficacy of surgery,and is worthy of further clinical application.