腰椎PLIF术后持续负压与间断负压引流效果的对比研究
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摘要
目的:比较腰椎后路椎间融合术(PLIF)术后患者术口采用持续负压引流与间断负压引流方式的临床效果。方法:对2016年1月—2017年6月我科腰椎行PLIF手术治疗患者61例进行回顾性分析,根据术后术口引流方式的不同,将其随机分为持续负压组(n=31)和间断负压组(n=30),统计两组患者术后总引流量、术后拔管时血红蛋白量及术后术口并发症(包括术口再渗血、皮下积血、感染等)。结果:两组患者年龄、性别、疾病类型、手术时间、术中出血量比较差异均无统计学意义(P>0. 05),具有可比性。间断负压组术后总引流量小于持续负压组,差异有统计学意义(P <0. 05)。间断负压组术后拔管时血红蛋白量高于持续负压组,差异有统计学意义(P <0. 05)。两组拔除引流管后均未出现明显术口再渗血、皮下积血、感染等并发症。结论:腰椎PLIF术后采用间断负压引流方式可明显减少术后引流血量,降低术后术口并发症,是一种较好的引流方式。
Objective: To compare the clinical effect in continuous negative pressure drainage versus and intermittent drainage after Lumbar PLIF Surgery. Methods: A retrospective study was performed in 61 lumbar spine disease treated by PLIF operation from January2016 to June 2017 were divided into continuous negative pressure drainage group( n = 31) and intermittent drainage group( n = 30)randomly according to different drainage way. The total volume of drainage,volume of hemoglobin and postoperative incision complications( including re-oozing of blood,subcutaneous blood accumulation and infection) were observed and compared between the two groups. Results: There was no significant difference between the two groups in age,sex,disease type,operation time and intraoperative blood loss( P > 0. 05). The intermittent drainage group had statistically less total volume of drainage than the continuous negative pressure drainage group( P < 0. 05). The volume of hemoglobin in intermittent drainage group was higher than the alternative group( P < 0.05). There was no re-oozing bleeding,subcutaneous blood accumulation,and infection in both groups. Conclusion: The intermittent negative pressure drainage is a good drainage method for clinical selection which can significantly reduce postoperative drainage volume and reduce postoperative incision complications.
Objective: To compare the clinical effect in continuous negative pressure drainage versus and intermittent drainage after Lumbar PLIF Surgery. Methods: A retrospective study was performed in 61 lumbar spine disease treated by PLIF operation from January2016 to June 2017 were divided into continuous negative pressure drainage group( n = 31) and intermittent drainage group( n = 30)randomly according to different drainage way. The total volume of drainage,volume of hemoglobin and postoperative incision complications( including re-oozing of blood,subcutaneous blood accumulation and infection) were observed and compared between the two groups. Results: There was no significant difference between the two groups in age,sex,disease type,operation time and intraoperative blood loss( P > 0. 05). The intermittent drainage group had statistically less total volume of drainage than the continuous negative pressure drainage group( P < 0. 05). The volume of hemoglobin in intermittent drainage group was higher than the alternative group( P < 0.05). There was no re-oozing bleeding,subcutaneous blood accumulation,and infection in both groups. Conclusion: The intermittent negative pressure drainage is a good drainage method for clinical selection which can significantly reduce postoperative drainage volume and reduce postoperative incision complications.
引文
[1]Cloward RB. The treatment of ruptured lumbar spinal intervertebral discs; criteria for spinal fusion[J]. Am J Surg,1953,86(2):145-151.
[2]Fleege C,Rickert M,Rauschmann M. The PLIF and TLIF techniques:Indication,technique,advantages,and disadvantages[J]. Orthopade,2015,44(2):114-123.
[3]Butler JS,Burke JP,Dolan RT,et al. Risk analysis of blood transfusion requirements in emergency and elective spinal surgery[J]. Eur Spine J,2011,20(5):753-758.
[4]Cobb JP. Why use drains[J]. J Bone Joint Surg Br,1990,72(6):993-995.
[5]Hare GM,Tsui AK,Ozawa S,et al. Anaemia:can we define haemoglobin thresholds for impaired oxygen homeostasis and suggest new strategies for treatment[J]. Best Pract Res Clin Anaesthesiol,2013,27(1):85-98.
[6]Li T,Zhuang Q,Weng X,et a1. Non-continuous versus continuous wound drainage after total knee arthroplasty:a meta-analysis[J].Int Orthop,2014,38(2):361-371.
[7]Beer KJ,Lombardi AV Jr,Mallory TH. The efficacy of suction drains after routine total joint arthroplasty[J]. J Bone Joint Surg Am,1991,73(4):584-587.
[8]Cobb JP. Why use drains[J]. J Bone Joint Surg Br,1990,72(6):993-995.
[9]Aksoy Y,Altinel L,Kose KC. The comparison of the effects of intraoperative bleeding control and postoperative drain clamping methods on the postoperative blood loss and the need for transfusion following total knee arthroplasty[J]. Acta Orthop Traumatol Turc,2011,45(3):190-194.
[10]Pornrattanamaneewong C,Narkbunnam R,Siriwattanasakul P,et al.Three hour interval drain clamping reduces postoperative bleeding in total knee arthroplasty a prospective randomized controlled trial[J].Arch Orthop Trauma Surg,2012,132(7):1 059-1 063.
[11]Li T,Zhuang Q,Weng X,et al. Non continuous versus continuous wound drainage after total knee arthroplasty a meta analysis[J]. Int Orthop,2014,38(2):361-371.
[12]袁相伟,王义生.全髋关节置换后夹闭引流管对引流量的影响[J].中国组织工程研究,2014,18(26):4 125-4 130.
[13]汤俊峰,尚希福,胡飞,等.全髋关节置换术后引流管不同处理方式的临床比较研究[J].中国骨与关节损伤杂志,2014,29(4):319-321.
[2]Fleege C,Rickert M,Rauschmann M. The PLIF and TLIF techniques:Indication,technique,advantages,and disadvantages[J]. Orthopade,2015,44(2):114-123.
[3]Butler JS,Burke JP,Dolan RT,et al. Risk analysis of blood transfusion requirements in emergency and elective spinal surgery[J]. Eur Spine J,2011,20(5):753-758.
[4]Cobb JP. Why use drains[J]. J Bone Joint Surg Br,1990,72(6):993-995.
[5]Hare GM,Tsui AK,Ozawa S,et al. Anaemia:can we define haemoglobin thresholds for impaired oxygen homeostasis and suggest new strategies for treatment[J]. Best Pract Res Clin Anaesthesiol,2013,27(1):85-98.
[6]Li T,Zhuang Q,Weng X,et a1. Non-continuous versus continuous wound drainage after total knee arthroplasty:a meta-analysis[J].Int Orthop,2014,38(2):361-371.
[7]Beer KJ,Lombardi AV Jr,Mallory TH. The efficacy of suction drains after routine total joint arthroplasty[J]. J Bone Joint Surg Am,1991,73(4):584-587.
[8]Cobb JP. Why use drains[J]. J Bone Joint Surg Br,1990,72(6):993-995.
[9]Aksoy Y,Altinel L,Kose KC. The comparison of the effects of intraoperative bleeding control and postoperative drain clamping methods on the postoperative blood loss and the need for transfusion following total knee arthroplasty[J]. Acta Orthop Traumatol Turc,2011,45(3):190-194.
[10]Pornrattanamaneewong C,Narkbunnam R,Siriwattanasakul P,et al.Three hour interval drain clamping reduces postoperative bleeding in total knee arthroplasty a prospective randomized controlled trial[J].Arch Orthop Trauma Surg,2012,132(7):1 059-1 063.
[11]Li T,Zhuang Q,Weng X,et al. Non continuous versus continuous wound drainage after total knee arthroplasty a meta analysis[J]. Int Orthop,2014,38(2):361-371.
[12]袁相伟,王义生.全髋关节置换后夹闭引流管对引流量的影响[J].中国组织工程研究,2014,18(26):4 125-4 130.
[13]汤俊峰,尚希福,胡飞,等.全髋关节置换术后引流管不同处理方式的临床比较研究[J].中国骨与关节损伤杂志,2014,29(4):319-321.