摘要
目的探讨脉冲高速冲洗方法对于后路脊柱手术的临床效果。方法选择我科2012年8月至2013年7月因腰椎间盘突出或椎管狭窄而行单节段椎间融合后路内固定治疗患者80例,术中应用高压脉冲冲洗者40例(实验组),应用常规倾倒冲洗者40例(对照组),观察对比两组患者术后伤口引流总量、术后第二天伤口引流液内炎性因子(TNF-α,IL-1,IL-6)表达情况及术后第5天血沉及C反应蛋白变化,并进行统计学分析。结果术后伤口引流总量方面,高压脉冲冲洗组为(389.37±109.89)ml,明显高于常规倾倒冲洗组[(275.77±102.00)ml]。术后早期患者伤口引流液TNF-α,IL-1,IL-6分别为(15.06±3.04)ng/L、(13.83±4.13)ng/L、(12.20±3.41)ng/L,显著低于对照组[(25.40±8.45)ng/L、(22.60±4.49)ng/L、(24.58±7.69)ng/L],而全身炎症反应指标血沉及C反应蛋白两组间无明显差异。结论脉冲高压冲洗对于腰椎后路手术是一种有效的切口清理方法,且能降低患者术后手术切口内局部炎性反应,值得临床推广与应用。
Objective To investigate the clinical efficacy of Pulsed Lavage in lumbar posterior single-segment fu-sion surgery. Methods Eighty patients diagnosed with single-segment lumbar disc herniation or lumbar spinal stenosis and needed a surgery treatment were assigned to receive surgical flush with either pulsed lavage （observation group, n=40） or artificial dumping rinse（the control group, n=40）.The surgical flush time, the nature and volume of fluid drainage, the In-flammatory factors（TNF-α, IL-1、6） of the fluid drainage in the 2th day, the Erythrocyte Sedimentation Rata（ESR） and the C-reactive protein（CRP）in the 5th day were compared between the two groups. Results The observation group had short-er surgical flush time, less volume of fluid drainage and inflammatory factor（TNF-α, IL-1, 6）expression（P＆lt; 0.05）. But no significant differences in the Erythrocyte Sedimentation Rata （ESR） and the C-reactive protein （CRP）in the 5th day were found between the two groups （P ＆gt; 0.05）. Conclusion These results suggested that pulsed lavage device is effective in lumbar posterior single-segment fusion surgery, and can decrease the concentrations of inflammatory factors in fluid drainage, and should be recommended in patients who are affordable.
出处
《北京医学》
CAS
2014年第4期286-288,共3页
Beijing Medical Journal
