摘要
目的 探讨腰椎后路手术患者隐性失血的影响因素。方法 对2016年1月至2020年2月贵州医科大学附属医院骨科行腰椎后路手术治疗的腰椎管狭窄症和腰椎间盘突出症患者114例的临床资料进行回顾性分析。其中男62例(54.39%),女52例(45.61%);年龄为(49.5±12.6)(24~76)岁;体质量指数(BMI)为(23.2±2.8)(17.3~29.5)kg/m^(2);其中35例患者合并高血压、糖尿病等基础疾病;其中双节段手术最多(55例,48.25%);手术方式以“经后路切开复位+椎管减压+神经根松解+植骨融合内固定术”为主(48例,42.11%);术中采用自体输血61例(53.51%);使用氨甲环酸止血48例(42.11%);手术时间<180 min患者70例(61.40%)。记录患者术中和术后24 h失血量。通过单因素分析和多元线性回归分析寻找24 h隐性失血量的影响因素。结果 手术节段、手术方式、输血情况、是否使用止血药以及手术时间与患者术后隐性失血量存在相关性(均P<0.001)。结论 腰椎后路手术患者围手术期是否使用氨甲环酸止血、手术方式、手术节段数量、输血情况以及手术时间均为术后24 h隐性失血量的影响因素;患者的性别、年龄、BMI以及合并基础疾病与术后24 h隐性失血量无相关性。
Objective To investigate the influencing factors of the volume of hidden blood loss in posterior lumbar surgery.Methods Data of 114 patients with lumbar spinal stenosis or lumbar disc herniation underwent posterior lumbar surgery in the Department of Spine Surgery,the Hospital Affiliated to Guizhou Medical University from January 2016 to February 2020 were analyzed retrospectively.There were 62(54.39%)males and 52(45.61%)females,with an age of(49.5±12.6)(24-76)years.The body mass index(BMI)was(23.2±2.8)(17.3-29.5)kg/m^(2),and 35 patients had underlying diseases such as hypertension and diabetes.Double segment surgery accounted for the largest proportion of 55 cases(48.25%).The operation of"posterior open reduction+spinal canal decompression+nerve root release,bone graft fusion and internal fixation"accounted for the largest proportion of of 48 cases(42.11%).Sixty-one(53.51%)patients underwent intraoperative autotransfusion.Forty-eight(42.11%)patients received tranexamic acid to stop bleeding.The operation time was less than 180 min in 70(61.40%)patients.The intraoperative and 24 h postoperatively blood loss were recorded for all patients.Univariate analysis and multiple linear regression analysis were used to explore the related factors of 24 h hidden blood loss in patients with posterior lumbar surgery.Results The number of operation segment,operation method,blood transfusion,whether to use hemostatic drugs and operation time were correlated with the postoperative hidden blood loss(all P<0.01).Conclusion Whether the hemostatic tranexamic acid was used in the perioperative period,the operation method,the surgery levels,the transfusion situation and the operation time were all the influencing factors of the 24 h postoperatively hidden blood loss.And there was no significant correlation between hidden blood loss and sex,age,BMI and combined underlying diseases.
作者
邓罗义
杨华
宁旭
彭国璇
刘淼
孙红
Deng Luoyi;Yang Hua;Ning Xu;Peng Guoxuan;Liu Miao;Sun Hong(Department of Orthopedics, the Hospital Affiliated to Guizhou Medical University, Guiyang 550004, China)
出处
《骨科临床与研究杂志》
2022年第4期245-250,共6页
Journal Of Clinical Orthopedics And Research
关键词
失血
手术
手术后出血
腰椎
外科手术
影响因素分析
Blood loss,surgical
Postoperative hemorrhage
Lumbar vertebrae
Surgical procedures,operative
Root cause analysis
