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可连续脉冲水球在腰椎融合手术中预防感染的作用

Effect of preventing infection for a continuous pulsing water ball in lumbar surgery
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摘要 目的探讨可连续脉冲冲洗水球在多节段腰椎后路融合手术中预防感染的作用。方法选取沈阳军区总医院骨科2016年6月至12月接受多节段腰椎后路融合手术的腰椎间盘突出或椎管狭窄患者30例,采用随机数字表法分为2组,观察组15例术中应用可连续脉冲冲洗,对照组15例应用常规倾倒,观察对比2组患者术中冲洗时间、C反应蛋白术后情况、切口拆线时间、术后发热病例及切口愈合情况。结果观察组术中冲洗时间(2.13±0.15)min少于对照组(5.59±1.24)min,2组比较差异有统计学意义(P<0.05);术后1、3、5 d观察组C反应蛋白数值成下降趋势,对照组成增高趋势;观察组切口平均拆线时间(11.57 d)少于对照组(14.29 d),2组比较差异有统计学意义(P<0.05);观察组术后3、5 d体温变化[(37.1±2.26)℃、(37.0±0.12)℃]低于对照组[(38.2±3.34)℃、(37.5±0.25)℃],2组比较差异有统计学意义(P<0.05)。结论与常规倾倒冲洗方法相比,可连续脉冲冲洗水球应用于多节段腰椎后路融合手术中缩短了冲洗时间,且能减少切口炎症反应。 Objective To study the effect of the continuous pulsing water ball in preventing infection in the multi-level posterior lumbar interbody fusion(PLIF). Methods From June 2016 to December 2016,thirty patients who were treated with multi-level posterior lumbar in- terbody fusion in our hospital were randomly divided into two groups.The 15 patients in the observation group were given continuous pulsing water ball, and the other 15 patients in the control group were given conventional dumping. The items including the time of intraoperative washing, the C-reactive protein( CRP), the time of suture clearing, post- operative fever cases and postoperative incision healing were oberved and compared between the two groups. Results The time of intraoperative washing was ( 2.13±0.15 ) min in the observation group and ( 5.59 ± 1.24 ) min in the conrtrol group, and the difference was statistically significant ( P 〈 0.05 ). The postoperative CRP of 1 st,3rd, and 5th day in the observation group was declining, whileas the control group was increasing. The time of suture clearing in the oberation group was 11.57 d, which was significantly less than 14.29 d the control group. The temperature of 3rd and 5th day after opreation in the obervation group was ( 37.1 ±2.26) ℃ and (37.0±0.12) ℃ respectively, which were significantly lower than (38.2 ±3.34)℃ and (37.5 ± 0.25 )℃ respectively the control group, and the difference was statistically significant (P 〈0.05). Conclusion Compared to the the conventional dumping, the continuous pulsing water ball has the some advantages in the multi-level posterior lumbar interbody fusion (PLIF), such as decreasing the washing time and reducing the local inflammatory reponse.
出处 《局解手术学杂志》 2017年第9期668-671,共4页 Journal of Regional Anatomy and Operative Surgery
基金 解放军总后勤部卫生部科研基金(野战便携式开放性四肢骨折综合急救装备及临床研究)
关键词 可连续脉冲冲洗水球 腰椎后路融合手术 C反应蛋白 冲洗时间 切口感染寰椎 continuous pulsing water ball posterior lumbar interbody fusion C-reactive protein flushing time incisional infection
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