退行性腰椎滑脱术后发生脑脊液漏的独立危险因素分析  

Analysis of Independent Risk Factors for Cerebrospinal Fluid Leakage after Degenerative Lumbar Spondylolisthesis

作　　者：贺旭[1] 马雪峰[1] 刘恺[1] 马鹏飞 阮烨[1] HE Xu;MA Xuefeng;LIU Kai;MA Pengfei;RUAN Ye(Shenzhen Pingle Orthopedic Hospital, Shenzhen 518118, Guangdong China.)

机构地区：[1]广东深圳平乐骨伤科医院,广东深圳518118

出　　处：《中国中医骨伤科杂志》2018年第6期44-47,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:分析退行性腰椎滑脱术后发生脑脊液漏的独立危险因素,为临床提供参考。方法:收集2010年5月至2017年7月本院脊柱外科经手术治疗的200例退行性腰椎滑脱患者的病案资料,其中,手术后发生脑脊液漏者22例,未发生脑脊液漏者178例,以此归为研究组和对照组。筛选出基线指标(性别、年龄、体质量指数、高血压病史、糖尿病史、吸烟史、酗酒史等)和临床指标(滑脱部位、滑脱Meyerding分度、手术方式)以及手术相关指标(手术时间和医生年资)中与脑脊液漏相关的因素,再用Logistic回归分析,找出影响退行性腰椎滑脱术后发生脑脊液漏的独立危险因素。结果:1)单因素分析结果显示,70岁以上患者较70岁以下患者脑脊液漏的发生率更高,吸烟者较不吸烟者脑脊液漏的发生率更高,滑脱Meyerding分度为Ⅲ度和Ⅳ度者较Ⅰ度和Ⅱ度者脑脊液漏的发生率更高,行PLIF者较TLIF者脑脊液漏的发生率更高,差异有统计学意义(P<0.05)。2)Logistic回归分析显示,高龄、长期吸烟史、滑脱Meyerding分度、手术方式是导致退行性腰椎滑脱术后发生脑脊液漏的独立危险因素,差异有统计学意义(P<0.05)。结论:高龄、长期吸烟史、滑脱严重程度与手术方式的选择是导致退行性腰椎滑脱术后发生脑脊液漏的独立危险因素,值得临床重视。Objective：To analyze the independent risk factors of cerebrospinal fluid leakage after degenerative lumbar spondylolisthesis,and provide clinical reference.Methods：The data of 200 patients of degenerative lumbar spondylolisthesis treated by spine surgery in our hospital from May 2010 to July 2017 were collected.22 patients with cerebrospinal fluid leakage after operation and 178 patients without cerebrospinal fluid leakage were classified as study group and control group.The cerebrospinal fluid leakage related factors were screened out from baseline indicators（sex,age,body mass index,history of hypertension,history of diabetes,history of smoking,history of alcoholism,etc.）and clinical parameters（slippage,slippage Meyerding index,surgical procedure）and surgical related indicators（operation time and doctor＇s seniority）.Logistic regression analysis was then used to identify independent risk factors for cerebrospinal fluid leakage after degenerative lumbar spondylolisthesis.Results：1）The results of univariate analysis showed that the incidence of cerebrospinal fluid leakage in patients over 70 years old was higher than that in patients under 70 years old,and the incidence of cerebrospinal fluid leakage was higher in smokers than in non-smokers,and the incidence of cerebrospinal fluid leakage in Meyerding index grade Ⅲ and Ⅳ was higher than that of grade Ⅰ and Ⅱ,and the incidence of cerebrospinal fluid leakage in PLIF was higher than that in TLIF（P〈0.05）.2）Logistic regression analysis showed that the elderly,long-term smoking history,slippage Meyerding indexing and operation method were the independent risk factors of cerebrospinal fluid leakage after degenerative spondylolisthesis（P〈0.05）.Conclusion：The elderly,long-term smoking history,the severity of spondylolisthesis and the choice of surgical procedure are the independent risk factors of cerebrospinal fluid leakage after degenerative lumbar spondylolisthesis,which is worthy of clinical attention.

关 键 词：退行性腰椎滑脱 脑脊液漏 独立危险因素 

分 类 号：R681.5[医药卫生—骨科学]