摘要
[目的]分析腰椎管狭窄症术后患者伤口采用不同引流方法的效果,探讨腰椎管狭窄症患者术后伤口引流的有效管理策略。[方法]回顾性分析2014年1月~2015年1月我院脊柱外科行单节段腰椎后路全椎板切除减压、椎间植骨融合内固定术的96例腰椎管狭窄症患者,男41例,女55例。根据术后伤口引流方式分为两组:一组为持续负压组,共48例,术后伤口引流使用一次性引流器,给予负压(1/2个大气压);另一组为交替压力组,共48例,术后24 h之内伤口引流使用一次性引流器,给予负压吸引,24 h之后更换为一次性引流袋,给予常压。分析两组患者术后总引流量(ml)、卧床时间、视觉疼痛模拟评分(VAS)。[结果]术后伤口总引流量持续负压组为(329.52±85.23)ml,交替压力组为(195.43±38.57)ml,两组患者差异有统计学意义(P<0.001)。卧床时间持续负压组患者为(5.30±1.69)d,交替压力组患者为(5.16±2.14)d,两组差异无统计学意义(P=0.585)。两组患者VAS评分术后均较术前显著下降,两时间点间差异均有统计学意义(P<0.05),但相同时间点两组间比较差异均无统计学意义(P>0.05)。[结论]腰椎管狭窄症术后采用负压引流和交替压力引流均能获得较好的下腰痛疼痛缓解率,而采用交替压力引流,术后总引流量少,是一种较好的术后引流方式。
[Objective] To compare outcome of continuous negative pressure versus alternative pressure drainages after surgical treatment of lumbar spinal stenosis. [Methods] Ninety-six patients with lumbar spinal stenosis, including 41 males and 55 females, underwent posterior lumbar interbody fusion （PLIF） surgery from January 2014 to January 2015. After surgery, the patients were randomly divided into the continuous group （n= 48） with continuous negative pressure drainage for a total of 48h and the alternative group （n=48） with negative pressure drainage for first 24h and atmospheric pressure for next 24h. The total volume of drainage, bed rest time and VAS were observed and compared between two groups. [Results] The total volume of drainage was recorded （329.52±85.23） ml in the continuous group, whereas （195.43±38.57） ml in the alternative group, with a significant difference （P〈0.01）. The post-surgery bed rest time [5.30± 1.69） days versus （5.16±2.14） days] was not statistically different between the two groups （P=0.585）. The VAS significantly decreased after operation compared those before operation with statistical differences between the two time points in both groups （P〈0.01）, however, no significant differences were noted between the two group at the same time points （P〉0.05）. [Conclusion] Although both continuous negative pressure and alterna- tive pressure drainage get similar satisfactory results after surgical treatment for lumbar spinal stenosis, alternative pressure drainage is still recommended for less total volume of drainage.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2017年第23期2148-2151,共4页
Orthopedic Journal of China
基金
河北省卫生厅科研项目资助(编号:ZL20140088)
关键词
腰椎管狭窄症
持续负压
交替压力
引流
lumbar spinal stenosis, continuous negative pressure, alternative pressure, drainage
