腰椎退行性疾病行TLIF围手术期隐性失血的影响因素分析  

Analysis of influencing factors of hidden blood loss in perioperative period of TLIF for lumbar degenerative disease

作　　者：查本义 周涛[1,2] 汪红亮 周捷 李健 ZHA Benyi;ZHOU Tao;WANG Hongliang;ZHOU Jie;LI Jian(Ma'anshan Clinical College of Anhui Medical University,Ma'anshan 243000;Spinal Orthopedics Department,Ma'anshan People's Hospital,Ma'anshan 243000,China)

机构地区：[1]安徽医科大学马鞍山临床学院,安徽马鞍山243000 [2]安徽省马鞍山市人民医院脊柱骨科,安徽马鞍山243000

出　　处：《临床医学研究与实践》2025年第7期41-44,共4页Clinical Research and Practice

基　　金：安徽省卫生健康科研项目(No.AHWJ2023A20227)。

摘　　要：目的分析腰椎退行性疾病(LDD)行经椎间孔入路腰椎椎间融合术(TLIF)围手术期隐性失血的影响因素。方法选取2022年8月至2023年12月于脊柱骨科因LDD行TLIF治疗的102例患者为研究对象,均行TLIF治疗。收集患者临床资料,参照Sehat公式计算术后隐性失血量,根据术后隐性失血量将患者分为低隐性失血组与高隐性失血组,采用多因素Logistic回归分析探究LDD患者TLIF围手术期隐性失血的影响因素。结果102例LDD患者中,低隐性失血组48例,高隐性失血组54例,围手术期估计总失血量为(1123.34±566.22)mL,显性失血量为(467.53±203.31)mL,隐性失血量为(515.20±255.34)mL。两组患者的年龄、高血压占比、手术节段、视觉模拟评分法(VAS)及汉密尔顿焦虑量表(HAMA)评分比较,差异具有统计学意义(P<0.05);两组的性别、身体质量指数(BMI)以及糖尿病、高脂血症、吸烟饮酒史占比比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,术前合并高血压、手术节段增加、术后1 d VAS及HAMA评分增加是LDD患者TLIF围手术期高隐性失血量的独立危险因素(P<0.05)。结论LDD患者行TLIF围手术期存在一定程度的隐性失血,且手术节段增加、术前合并高血压、术后1 d VAS及HAMA评分增加是TLIF围手术期高隐性失血量发生的独立危险因素。Objective To analyze the influencing factors of hidden blood loss in perioperative period of transforaminal lumbar interbody fusion(TLIF)for lumbar degenerative disease(LDD).Methods From August 2022 to December 2023,102 patients who underwent TLIF for LDD in the spinal orthopedics department were selected as the research objects,all patients were treated with TLIF.The clinical data of the patients were collected,and the postoperative hidden blood loss was calculated according to the Sehat formula.The patients were divided into low hidden blood loss group and high hidden blood loss group according to the postoperative hidden blood loss.Multivariate Logistic regression analysis was used to explore the influencing factors of hidden blood loss during TLIF perioperative period in LDD patients.Results Among the 102 LDD patients,there were 48 cases in the low hidden blood loss group and 54 cases in the high hidden blood loss group,the estimated total perioperative blood loss was(1123.34±566.22)mL,the dominant blood loss was(467.53±203.31)mL,and the hidden blood loss was(515.20±255.34)mL.There were significant differences in age,hypertension proportion,surgical segment,Visual Analogue Score(VAS)and Hamilton Anxiety Scale(HAMA)scores between the two groups(P<0.05);there were no significant differences in gender,body mass index(BMI)and the proportions of diabetes,hyperlipidemia,smoking and drinking history between the two groups(P>0.05).Multivariate Logistic regression analysis results showed that preoperative hypertension,increased surgical segments,and elevated VAS and HAMA scores at 1 d after surgery were independent risk factors for high hidden blood loss during TLIF in LDD patients(P<0.05).Conclusion There is a certain degree of hidden blood loss in LDD patients undergoing TLIF during the perioperative period,increased surgical segment,preoperative hypertension,and elevated VAS and HAMA scores at 1 d after surgery are independent risk factors for high hidden blood loss during TLIF.

关 键 词：腰椎退行性疾病 经椎间孔入路腰椎椎间融合术 隐性失血 危险因素 围手术期 

分 类 号：R687.3[医药卫生—骨科学]