单侧与双侧引流对颈椎后路全椎板切除侧块螺钉内固定术后主要并发症的影响  

Effect of unilateral or bilateral drainages on main complications after posterior cervical total laminectomy with lateral block screw internal fixation

作　　者：曹江 常杰 黄子彦 曹晓建 眭涛 Cao Jiang;Chang Jie;Huang Ziyan;Cao Xiaojian;Sui Tao(Department of Orthopaedics,Jiangsu Province Hospital,First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China)

机构地区：[1]江苏省人民医院(南京医科大学第一附属医院)骨科,南京210029

出　　处：《脊柱外科杂志》2021年第2期79-82,88,共5页Journal of Spinal Surgery

基　　金：国家自然科学基金面上项目(81672152,81871773);江苏省重点研发计划项目(BE2018132)。

摘　　要：目的比较放置单侧与双侧引流管对颈椎后路全椎板切除侧块螺钉内固定术后主要并发症的影响,为引流方案的选择提供依据。方法回顾性分析2015年1月—2017年12月在本院接受颈椎后路全椎板切除侧块螺钉内固定术治疗的75例患者资料。根据引流管放置数量分为单侧组(n=45)和双侧组(n=30)。统计并比较2组患者年龄、性别、疾病类型(诊断结果)、合并基础疾病情况、手术时间、手术减压节段数、术后引流量、术后住院时间和术后临床症状缓解率,记录并比较2组术后切口异常渗血、切口感染、症状性硬膜外血肿等并发症发生情况。结果2组患者年龄、性别、疾病类型(诊断结果)、合并基础疾病、手术时间、手术减压节段数、术后引流量、术后住院时间及术后临床症状缓解率比较,差异均无统计学意义(P>0.05)。单侧组9例(20.0%)、双侧组1例(3.3%)发生术后并发症,组间比较,差异有统计学意义(P<0.05)。单侧组19例合并基础疾病的患者中7例(36.8%)发生术后并发症,双侧组12例合并基础疾病的患者均未发生并发症,差异有统计学意义(P<0.05)。结论双侧放置引流管可降低颈椎后路全椎板切除侧块螺钉内固定术后总体并发症的发生率,且对于伴有基础疾病的患者可能有更好的保护作用。Objective To compare the effects of placing unilateral or bilateral drainages on the main complications after posterior cervical total laminectomy with lateral block screw internal fixation,so as to provide the basis for the choice of drainage methods.Methods From January 2015 to December 2017,the clinical data of 75 patients who underwent posterior cervical total laminectomy with lateral block screw internal fixation were analyzed retrospectively.According to the number of drainage tube,the patients were divided into unilateral group(n=45)and bilateral group(n=30).The age,gender,diagnosis,combined basic diseases,operation time,number of surgical segments,postoperative drainage volume,postoperative hospital stay and rate of symptoms remission were recorded and compared between the 2 groups.The incidence of complications including abnormal bleeding in incision,infection in incision and symptomatic epidural hematoma were observed and compared between the 2 groups.Results There was no significant difference between the 2 groups in the age,gender,diagnosis,combined basic diseases,operation time,number of surgical segments,postoperative drainage volume,postoperative hospital stay and the rate of symptom remission(P>0.05).After surgery,number of complications was 9 of 45(20.0%)in the unilateral group,while 1 of 30(3.3%)in the bilateral group,with a significant difference(P<0.05).Nineteen patients combined basic diseases were included in the unilateral group,of which 7 developed postoperative complications(36.8%);in the bilateral group,there were 12 cases combined basic diseases,and no postoperative complications was observed.There was significant difference in the incidence of postoperative complications in the cases combined basic diseases between the 2 groups(P<0.05).Conclusion Bilateral drainages can significantly reduce the incidence of total complications after posterior cervical total laminectomy with lateral block screw internal fixation,and for patients combined basic diseases,bilateral drainage may have better

关 键 词：颈椎病 脊髓损伤 椎板切除术 内固定器 手术后并发症 

分 类 号：R681.531[医药卫生—骨科学]