摘要
目的探讨采用分光光度法评估经皮内窥镜下腰椎椎间盘切除术(PELD)中出血量的可行性。方法2018年3月-10月,采用PELD治疗腰椎椎间盘突出症(LDH)患者62例,分别使用分光光度法、血红蛋白计算法、目测法估算术中出血量。分光光度法将所测冲洗液的光密度(OD)值与氰化高铁血红蛋白标准液标准曲线的OD值相比测定血红蛋白浓度,再根据血红蛋白浓度计算出血量;血红蛋白计算法以术后全血血红蛋白下降程度为依据判断出血量;目测法根据术者个人经验判断出血量。结果分光光度法、血红蛋白计算法和目测法估算的PELD术中出血量分别为(51.85±27.48)mL、(216.00±155.91)mL和(32.17±20.11)mL,分光光度法估算的出血量低于血红蛋白计算法,但高于目测法,差异均有统计学意义(P<0.05)。结论由于PELD利用水作为介质,术中出血被冲洗液大量稀释,难以准确判断术中出血量。分光光度法受标本影响小,可客观地定量检测出血量,为此类手术的术中出血量的判断提供了新的选择。
Objective To explore the feasibility of estimation of blood loss during percutaneous endoscopic lumbar discectomy(PELD)by spectrophotometry.Methods From March 2018 to October 2018,62 patients with lumbar disc herniation(LDH)were treated with PELD.The intraoperative blood loss was estimated by spectrophotometry,hemoglobin calculation and visual observation.The optical density(OD)value of the washing solution measured by spectrophotometry was compared with the OD value of the standard curve of hemiglobincyanide standard solution to determine the hemoglobin concentration,and then the blood loss was calculated according to the hemoglobin concentration.Hemoglobin calculation method was used to calculate the blood loss based on the postoperative decrease of whole blood hemoglobin.The visual observation method was used to evaluate the blood loss volume by the operator’s personal experience.Results The amount of blood loss was(51.85±27.48)mL,(216.00±155.91)mL and(32.17±20.11)mL estimated by spectrophotometry,hemoglobin calculation and visual observation,respectively.The blood loss measured by spectrophotometry was less than that measured by hemoglobin calculation,while more than that measured by visual observation,all with statistical significances(P<0.05).Conclusion The blood loss during PELD is difficult to accurately determine because the intraoperative blood loss was diluted by rinse solution which is used as the medium during the operation.Spectrophotometry is less affected by specimens and can objectively and quantitatively detect the blood loss,which provides a new choice for judging the blood loss during such operations.
作者
夏宇
晏铮剑
高翔
王可然
杜宇
唐锴鹰
张汛
陈亮
XIA Yu;YAN Zheng-jian;GAO Xiang;WANG Ke-ran;DU Yu;TANG Kai-ying;ZHANG Xun;CHEN Liang(Department of Orthopaedics,Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)
出处
《脊柱外科杂志》
2019年第6期415-418,共4页
Journal of Spinal Surgery
关键词
腰椎
椎间盘移位
内窥镜检查
减压术
外科
外科手术
微创性
失血
手术
Lumbar vertebrae
Intervertebral disc displacemen
Endoscopy
Decompression,surgical
Surgical procedures,minimally invasive
Blood loss,surgical
