腰椎后路术后切口脂肪液化的危险因素分析  

Analysis of risk factors for fat liquefaction of incision after posterior lumbar surgery

作　　者：张通 韩兴文[1] 宋正东 王文己[1] Zhang Tong;Han Xing-wen;Song Zheng-dong;Wang Wen-ji(Department of Orthopedics,The First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一医院骨科,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2022年第3期38-42,共5页Journal of Lanzhou University（Medical Sciences）

基　　金：兰州大学第一医院院内科研基金资助项目(ldyyyn2021-31)。

摘　　要：目的分析腰椎后路手术中引起术后切口脂肪液化的危险因素,以期预防和减少术后切口脂肪液化。方法选取2018年6月-2019年6月在兰州大学第一医院骨科行腰椎后路椎管减压+髓核切除+椎弓根螺钉固定术的297例患者为研究对象,根据患者的临床资料,采用Logistics多因素回归分析术后切口脂肪液化的危险因素。结果297例患者中出现脂肪液化47例,脂肪液化率为15.82%;手术节段≥3个、吸烟、合并糖尿病、年龄≥60岁、合并高血压、手术时间≥2.5 h、肥胖、传统分层缝合、血清白蛋白<35 g/L、用高频电刀切开脂肪层的脂肪液化率较高,差异均有统计学意义(P<0.05)。结论手术节段≥3个、吸烟、合并糖尿病、年龄≥60岁是腰椎后路术后切口脂肪液化的独立危险因素,可在临床中制定相对预防措施。Objective To analyze the risk factors for incision fat liquefaction after posterior lumbar surgery,so as to prevent and reduce the occurrence of incision fat liquefaction.Methods From June 2018 to June 2019,297 patients who underwent posterior lumbar spinal canal decompression+nucleus pulpectomy+pedicle screw fixation in the Department of Orthopedics,the First Hospital of Lanzhou University,were selected as the study object.According to the clinical data of the patients,the risk factors for incision fat liquefaction were analyzed by a Logistics regression analysis.Results Among 297 patients,47 had fat liquefaction,with the rate being 15.82%.The ratio of≥60 years old with hypertension and smoking,the operation segment≥3 with diabetes,the operation time≥2.5 h.Serum albumin<35 g/L and the fat layer cut with a high-frequency electric knife in incision fat liquefaction was significantly higher(P<0.05).Conclusion The independent risk factors of incision fat liquefaction after posterior lumbar surgery are more than 3 operative segments,smoking,diabetes mellitus and age≥60 years old.Relative preventive measures can be made in clinical practice.

关 键 词：腰椎后路术后 脂肪液化 危险因素 

分 类 号：R459.9[医药卫生—治疗学]