摘要
为了探究不同患者发生脑脊液漏的诱发原因与相关危险因素,为预防临床手术治疗脊椎滑脱后的并发症提供参考,本研究选取2013年1月至2016年7月于重庆市中医院接受骨科腰椎滑脱术的患者214例作为研究对象。根据患者的不同情况进行腰椎后路椎间融合手术(PLIF)或经椎间孔间融合手术(TLIF),于术中与术后观察患者是否发生脑脊液漏。有脑脊液漏并发者归为观察组,共28例;无脑脊液漏并发者为对照组,共186例。收集患者的资料,通过回顾性分析,进行统计学比较。发现,患者年龄超过70岁(OR=2.088,95%CI=1.079~4.286)、有吸烟史(OR=1.774,95%CI=1.321~2.894)、Meyerding分度高(OR=2.617,95%CI=1.032~3.672)是造成患者术后脑脊液漏的危险因素。主要原因为,降低硬脊膜的柔韧性,使硬脊膜厚度变薄;患者术后生活中,因发生硬脊膜内外压快速改变,导致硬脊膜发生破裂,造成脑脊液漏。滑脱病程时间与患者术后发生脑脊液漏相关,但无显著影响。
The aim of study was to explore the causes and related risk factors of leakage of CSF in different patients, so as to provide reference for preventing clinical complications after surgical treatment of spondylolisthesis. We selected 214 cases of patients undergoing orthopaedic lumbar spine surgery in Chongqing Traditional Chinese Medicine Hospital from January 2013 to July 2016 as the research object. Patients were treated with posterior lumbar interbody fusion （PL1F） or transforaminal lumbar interbody fusion （TLIF） according to their different situations. We took intraoperative and postoperative observation of the patients if there were leakage of cerebrospinal fluid. The ones who had leakage of cerebrospinal fluid were classified as observation group, and there were a total of 28 cases. The rest was classified as a control with a total of 186 cases. The patient＇s information was collected and statistically compared by retrospective analysis. We found that these risk factors caused postoperative cerebrospinal fluid leakage in patients： patients older than 70 years old （OR=2.088, 95% CI=2.088-4.286）, having a history of smoking （OR=1.774, 95% CI=1.774-2.894）, high Meyerding dividing （OR=2.617, 95% CI=2.617-3.672）. The main reason might be reducing the flexibility of the catheter, which maked stiff backbone thinner. In patients＇ postoperative life, there was fast change of internal and external pressure of stiff backbone, leading to the catheter fracture and causing cerebrospinal fluid leakage. Slippage duration time was associated with patients postoperative cerebrospinal fluid leak, but there was no significant influence...
出处
《基因组学与应用生物学》
CAS
CSCD
北大核心
2017年第8期3384-3389,共6页
Genomics and Applied Biology
基金
重庆市中医院资助
关键词
腰椎滑脱
脑脊液漏
发生率
危险因素
Lumbar olisthe, Cerebrospinal fluid leakage, Occurrence rate, Risk factors
