腰椎后路手术切口脂肪液化的相关危险因素及预防对策  

Related risk factors and preventive strategies of fatty liquefaction in posterior lumbar spinal surgical incisions

作　　者：矫健航[1] 赵鑫梦 罗丽娟[1] 刘紫微 王东旭[1] 王洋 杨利丽[1] JIAO Jianhang;ZHAO Xinmeng;LUO Lijuan;LIU Ziwei;WANG Dongxu;WANG Yang;YANG Lili(The Second Hospital of Jilin University,Changchun 130041,China)

机构地区：[1]吉林大学第二医院,长春130041

出　　处：《长春中医药大学学报》2023年第10期1172-1175,共4页Journal of Changchun University of Chinese Medicine

基　　金：吉林省科技发展项目(20210204104YY、YDZJ202201ZYTS135);吉林大学本科教学改革研究项目(2021XZC100)。

摘　　要：切口脂肪液化逐渐成为腰椎后路手术常见的术后并发症。肥胖、合并糖尿病、高频电刀使用不当、手术时间过长、术中出血量大、缝合技术欠佳等是腰椎后路手术切口脂肪液化的危险因素。患者围手术期应控制血糖在8 mmol·L^(-1)以下;术中尽可能缩短手术时长,控制出血,合理使用高频电刀,必要时可采用生理盐水纱布覆盖两侧切缘;缝合切口前应充分浸泡、冲洗切口,建议采用深筋膜层全层缝合以及皮内缝合技术。此外,良好的术后护理是加快切口愈合的关键。Incisional fatty liquefaction has gradually become a common postoperative complication of posterior lumbar spinal surgery.Obesity,combined diabetes mellitus,improper use of high-frequency electric knife,prolonged operation time,a large amount of intraoperative bleeding,and poor suturing technique are the risk factors for incisional fatty liquefaction in posterior lumbar spinal surgery.To prevent fatty liquefaction,the blood sugar level of the patients should be controled below 8 mmol•L^(-1)during the perioperative period;During surgery,surgeons should try to shorten the operation duration as much as possible,control bleeding,use high-frequency electric knives reasonably,and use saline gauze to cover both sides of the incision margin if necessary;Before suturing the incision,it should be thoroughly soaked and rinsed.It is recommended to use deep fascial layer full suture as well as intradermal suturing techniques.In addition,good postoperative care is the key to speed up the healing of the incision.

关 键 词：腰椎后路手术 脂肪液化 术后并发症 相关因素 预防 

分 类 号：R681.5[医药卫生—骨科学]