术后反应性疼痛与引流液炎症因子相关性  

Correlation between lumbar spinal reactive pain and inflammatory factors in drainage fluid after lumbar spinal surgery

作　　者：赵广民[1] 阴彦斌[2] 刘秀梅[1] 李放[1] 

机构地区：[1]北京军区总医院脊柱外科,全军创伤骨科研究所,北京100700 [2]山西医科大学第二临床医学系,山西030001

出　　处：《脊柱外科杂志》2016年第2期106-110,共5页Journal of Spinal Surgery

摘　　要：目的探讨腰椎术后反应性疼痛与引流液中炎症因子的相关性。方法 2012年3月—7月,40例单节段腰椎椎间盘突出患者在本院行单节段腰椎后路椎板减压、椎间盘切除、椎间植骨融合内固定术。其中出现术后非切口部位的腰臀部或下肢疼痛13例。于术后1-3 d连续记录出现非切口部位疼痛的视觉模拟量表（VAS）评分。术后1-3 d连续留取伤口引流液,检测伤口局部炎症因子白介素-1β（IL-1β）、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平及外周血炎症因子水平;术后1-3 d连续检测红细胞沉降率（ESR）、C反应蛋白（CRP）。通过统计学分析,探讨炎症因子与疼痛程度、ESR及CRP的相关性。结果引流液IL-1β,IL-6,TNF-α水平与术后疼痛VAS评分呈正相关,而与血液中炎症因子水平无相关性,与ESR,CRP无相关性。结论腰椎术后反应性疼痛与术后引流液中IL-1β,IL-6,TNF-α水平显著相关,提示疼痛与术后炎症因子的局部增加有密切的关系。Objective To explore the correlation between lumbar spinal reactive pain and inflammatory factors in the drainage fluid after lumbar spinal surgery. Methods From March 2012 to July 2012,40 patients with single-level lumbar disc herniation were treated by posterior lumbar decompression,diskectomy,interbody fusion and internal fixation. Reactive pain of the low lumbar or lower limb occurred in 13 cases at post-operation. Visual analogue scale（VAS） score was recorded for low back pain at 1- 3 d post-operation. The interleukin-1β（IL-1β）,interleukin-6（IL-6） and tumor necrosis factor-α（TNF-α） were tested in wound drainage fluid and inflammatory factors in peripheral blood at 1- 3 d post-operation continuously. Erythrocyte sedimentation rate（ESR） and C-reaction protein（CRP） were assayed tested continuously at 1- 3 d post-operation. The correlations of inflammatory factors with pain intensity,ESR and CRP were explored by statistical analysis. Results The concentrations of IL-1β,IL-6 and TNF-α in drainage fluid at 2- 3 d postoperative were positively correlated with VAS score（P〈0.05）,but did not correlate with the inflammatory factor level,ESR and CRP in the peripheral blood（P〉0.05）. Conclusion The reactive pain after lumbar surgery is correlated with the concentration of IL-1β,IL-6 and TNF-α in drainage fluid,indicating that the pain has a close relationship with local increase of inflammatory factors after surgery.

关 键 词：腰椎 椎间盘移位 细胞因子类 疼痛 手术后 

分 类 号：R619.9[医药卫生—外科学]