下腰椎术后引流管中段抬高引流方式与持续负压引流的效果比较  

作　　者：郝庆英[1] 麻昊宁[1] 付婵娟 张晓华[1] 谭明生[1] 

机构地区：[1]中日友好医院脊柱外科,北京100029

出　　处：《中华现代护理杂志》2015年第13期1589-1593,共5页Chinese Journal of Modern Nursing

基　　金：中日友好医院院级课题（2013-HL-02）

摘　　要：目的探讨下腰椎术后患者引流管中段抬高及持续负压两种引流方式的引流量和护理方法。方法2008年1月-2013年7月，将248例行腰椎后路1～2节段手术的患者按照随机数字表法分为两组，其中研究组（A组）116例术后采用引流管抬高法引流，对照组（B组）132例术后给予持续负压引流。比较两组总引流量、手术前后血红蛋白浓度、术后体温、并发症及JOA评分情况。结果A组单节段平均引流量（97．0±34．2）ml，双节段平均引流量（108．5±32．7）ml；B组单节段平均引流量（393．4±143．5）ml，双节段平均引流量（448．2±169．6）ml；A、B组问单／双节段术后引流总量之间差异有统计学意义（t值分别为14．43，17．55；P〈0．01）；A组单／双节段，以及B组单／双节段术后引流量之间差异均无统计学意义（P〉0．05）。A、B两组患者术后第2天血红蛋白浓度分别为（121．7±13．4），（117．8±12．5）g／L，差异有统计学意义（t=2．38，P〈0．05），其余指标差异均无统计学意义。结论下腰椎术后引流管抬高引流法可明显减少术后失血量，改善临床效果，是一种值得进一步探讨的引流方法。Objective To investigate the drainage volume and nursing method of lifted tube drainage and continuous negative pressure drainage after lower lumbar surgery.Methods A total of 248 consecutive patients undergoing the first or second lumbar spine surgery from January 2008 to July 2013 were prospectively randomly divided into two groups.116 patients in the experimental group (group A) took the lifted tube drainage and 132 patients in the control group (group B) took the normal continuous negative pressure drainage protocol after surgery.The total drainage volume,pre-and post-operative hemoglobin,post-operative temperature,complications and JOA score in the two groups were compared.Results The average drainage volume after single or two segment surgery were (97.0 ± 34.2)ml and (108.5 ± 32.7)ml in group A.The average drainage volume after single or two segment lower lumbar surgery were (393.4 ± 143.5) ml and (448.2 ± 169.6) ml in group B,the difference was statistically significant (t =14.43,17.55,respectively;P ＜ 0.01).There was no significant difference in drainage volume in single or two segment in group A and B (P ＞ 0.05).The post-operative hemoglobin level was (121.7 ± 13.4) and (117.8 ± 12.5) g/L in group A and B respectively,the difference was statistically significant (t =2.38,P ＜ 0.05).Conclusions Based on the findings in this study,lifting the drainage tube to an appropriate height is a simple and safe way to reduce postoperative drainage volume in lower lumbar spine surgery which is worthy of further investigations.

关 键 词：下腰椎手术 引流 术后失血 

分 类 号：R473.6[医药卫生—护理学]