后路腰椎椎间融合术后伤口渗出的治疗转归  

Treatment outcomes of wound exudation after posterior lumbar interbody fusion operation

作　　者：李清江 董玉珍[1] 路坦[1] 连怡钧 崔明星[1] 赵斌[1] LI Qing-jiang;DONG Yu-zhen;LU Tan;LIAN Yi-jun;CUI Ming-xing;ZHAO Bin(The Second Ward,Department of Orthopaedic Surgery,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan,China)

机构地区：[1]新乡医学院第一附属医院骨外科二病区、河南省神经修复重点实验室,河南卫辉453100

出　　处：《广东医学》2024年第4期453-457,共5页Guangdong Medical Journal

基　　金：河南省神经修复重点实验室开放课题(HNSJXF-2021-016)。

摘　　要：目的探讨后路腰椎椎间融合术(posterior lumbar interbody fusion,PLIF)后伤口渗出的治疗转归,为临床治疗提供理论支持。方法回顾性分析2018年9月至2021年4月收治的因腰椎退行性疾病导致神经或脊髓损伤且经历PLIF术后出现伤口渗出的23例患者资料,根据其临床资料分为感染组(n=10)和非感染组(n=13)。总结比较两组患者的临床表现及治疗过程。结果与非感染组相比,感染组患者术中出血较多(P<0.05),术后感染确诊时间及伤口愈合时间较长(P<0.05),术后第3天血红蛋白(hemoglobin,HB)较低(P<0.05),而血白细胞(white blood cell,WBC)计数、中性粒细胞计数(absolute neutrophil count,ANC)、红细胞沉降率(erythrocyte sedimentation rate,ESR)及C-反应蛋白(C-reactive protein,CRP)较高(P<0.05)。所有患者均治愈出院,且经过1年以上随访无复发。结论PLIF术后伤口渗出后早期正确的鉴别和干预,可取得较好的临床疗效。Objective To explore the treatment outcome of surgical wound drainage following posterior lumbar interbody fusion(PLIF)surgery and provide theoretical support for clinical treatment.Methods A retrospective analysis was conducted on 23 patients who underwent PLIF surgery due to degenerative diseases of the lumbar spine resulting in neurological or spinal cord injury and subsequently developed wound drainage from September 2018 to April 2021.The patients were divided into the infection group(n=10)and the non-infection group(n=13)based on their clinical data.Clinical manifestations and treatment processes were summarized and compared between the two groups.Results Compared with the non-infection group,patients in the infection group had significantly more intraoperative bleeding(P<0.05),longer time to diagnosis of postoperative infection and wound healing(P<0.05),lower hemoglobin levels on the third day after surgery(P<0.05),and higher white blood cell count,absolute neutrophil count,erythrocyte sedimentation rate,and C-reactive protein levels(P<0.05).All patients were discharged after recovery,and no recurrence was observed during a follow-up period of more than one year.Conclusion Early and accurate identification and intervention for surgical wound drainage after PLIF surgery can achieve favorable clinical outcomes.

关 键 词：神经损伤 后路腰椎椎间融合术 渗出 感染 治疗 

分 类 号：R619[医药卫生—外科学] R681[医药卫生—临床医学]