腰椎间盘突出症术后血流变学变化及临床意义  

The Postoperative Hemorheologic Variance and the Clinical Significance of 52 Cases of Lumbar disc Herniation

作　　者：赵长庚[1] 曲春杰 周勇刚[1] 张永刚 范家骏[2] 雷泽著[3] 

机构地区：[1]解放军202医院,沈阳110003 [2]西安第四军医大学物理教研室 [3]西安第四军医大学卫生统计学教研室

出　　处：《骨与关节损伤杂志》1997年第4期202-204,共3页The Journal of Bone and Joint Injury

摘　　要：52例腰椎间盘突出症手术前后检测10项血流变学指标,配对比较8项指标。血流变指标与影响因素作多元回归分析,提示手术时间长、损伤重对红细胞比积降低影响大(P〈0.05),血沉及血沉方程K值升高与输液量有关(P〈0.05),单因素分析P〉0.05。术后不同时间血流变学变化存在着创伤应激反应使血粘度等指标升高和血液稀释使其降低两方面因素的影响。提示外科失血不宜等量输血,应“欠量”输血,适当补液维持低红细胞比积状态,以减少术后有关并发症。Ten hemorheological parameters were measured in 52 patients with lumbar disc herniation prior to and after discectomy and eight of the parameters were paired using t - test which showed very marked difference (P< 0. 01 ) , A multiple regression analysis of the hemorheological paremeters and affecting factors of variables revealed that long duration of operation and major surgical trauma to tissues exerted adverse effect on hematocrit (P< 0. 05 ) , and ESR and ESR-K value were related to fluid infusion volume (P<0. 05), where as analysis of the individual variables didn' t show significant differened (P>0. 05). The changes in hemorheological parameters at different points had some characteristics. The results with the study of perioperative changes in hemoheological parameters suggested that the stress of trauma leads to increased blood viscosity and hemodilution results in decreased viscosity. It is suggested that the transfusion volume had rather be insufficient than equivalent to the blood loss to keep a low hematocrit which is beneficial to preventing some complications.

关 键 词：血液流变学 腰椎 椎间盘突出 外科手术 

分 类 号：R681.530.5[医药卫生—骨科学]