目的:SARS-Cov-19大流行彻底改变了德国医院的日常工作。随着医院容量的减少,许多手术被推迟甚至取消。2020年3月25日,德国神经外科学会(DGNC)发表了一份声明,其中为每个神经外科领域定义了紧急非选择性手术。而选择性干预被推迟.目前的工作检查了这些Covid策略的影响,重点是在此期间到我们科室就诊的周围病变患者。
方法:纳入2018年1月至2022年12月在我们部门接受任何周围神经手术的所有患者。检查了包括压迫综合征在内的完整手术范围,包括周围神经病变,臂丛神经外伤性病变,单个周围神经的创伤性病变和肿瘤。之前比较了外科手术的数量,在大流行期间和之后。分析皮尔逊相关系数。
结果:从2018年到2022年,涉及周围神经的外科手术总数包括2422次手术。压缩综合症所占比例最大(1433次操作,59%),其次是周围神经损伤(445次手术,18%),周围神经肿瘤(344次手术,14%)和臂丛神经病变(142例手术,6%)。平均每月40,5次干预,范围是7-63。在此期间,发现周围神经手术数量下降了两次。第一次是在2020年4月和5月,平均分别下降了65%和41%。在这几个月中,平均手术次数为37次。第二次下降是从2021年10月到2022年1月,手术数量减少了16%,36%,83%和18%,平均操作次数为50次。两种下降均显示出与压缩综合征治疗次数减少的显着和强相关性(r=0.952,p<0.001和r=0.968,p<0.001),外伤性周围神经损伤(p=0.769,r=0.095和p=0.243,r=0.366)和外伤性臂丛神经损伤(p=0.787,r=0.088和p=0.780,r=0.09)的治疗没有发现下降且没有显着相关性。在周围神经肿瘤的治疗数量中观察到微弱的显着相关性(p=0.017,r=0.672和p=0.015,r=0.67)。
结论:Covid-19大流行导致神经减压次数显著减少,因为,根据德国神经外科学会的说法,这些被认为是选择性手术。
SARS-Cov-19 pandemic totally changed daily routine work in German hospitals. As hospital capacity was reduced, many surgeries were postponed or even cancelled. On March 25th 2020 the German Society of Neurosurgery (DGNC) published a statement in which urgent non-elective surgeries were defined for each neurosurgical domain, whereas elective interventions were deferred. The present work examines the impact of these Covid strategies focusing on patients with peripheral lesions who were conducted to our department during this period of time.
All patients who underwent any peripheral nerve surgery at our department from January 2018 until December 2022, were included. The complete range of surgeries including peripheral nerve lesions was examined encompassing compression syndromes, traumatic lesions of brachial plexus, traumatic lesions and tumors of single peripheral nerves. The numbers of surgical procedures were compared before, during and after pandemic. Pearson correlation coefficient was analysed.
From 2018 to 2022 the total number of surgical procedures involving peripheral nerves included 2422 procedures. Compression syndromes made up the largest proportion (1433 operations, 59%), followed by peripheral nerve lesions (445 operations, 18%), peripheral nerve tumors (344 operations, 14%) and lesions of the brachial plexus (142 operations, 6%). The average was 40,5 interventions per month, the range was 7-63. Two declines in the number of peripheral nerve surgeries were noted during this period. The first was in April and May 2020 with an average drop of 65% and 41% respectively. In these months the average number of operations was 37. The second decrease was from October 2021 until January 2022, where number of surgeries was reduced by 16%, 36%, 83% and 18% with an average number of 50 operations. Both declines showed a significant and strong correlation with the lower number of compression syndrome treatments (r = 0.952, p < 0.001 and r = 0.968, p < 0.001), while no drop and no significant correlation was found in the treatment of traumatic peripheral nerve injuries (p = 0.769, r = 0.095 and p = 0.243, r = 0.366) and traumatic brachial plexus injuries (p = 0.787, r = 0.088 and p = 0.780, r = 0.09). A weak significant correlation was seen in the treatment numbers of peripheral nerve tumors (p = 0.017, r = 0.672 and p = 0.015, r = 0.67).
Covid-19 pandemic lead to a significant decrease in the number of nerve decompressions, since, according to the German Society of Neurosurgery, those were considered as elective surgeries.