腰椎手术后侧入路切口愈合不良的原因分析

Analysis of Poor-healing on Posterior Approach of Lumbar Operation

目的分析影响腰椎手术后侧入路切口不愈合的因素及处理对策。方法总结322例腰椎后侧入路手术切口不愈合的发生率及临床表现、治疗和转归情况。结果Ⅰ期切口愈合率93.5%;Ⅱ期切口愈合率5.3%,痂下愈合率0.62%。结论影响切口愈合的常见因素主要有全身因素、镇痛药物、局部血液循环障碍、肥胖及脂肪液化、手术时局部热损伤效应、止血药物的局部应用、生物材料和无机材料、脑脊液漏、机械压迫或牵拉和缝合技术的影响,在施行该类手术时应该有针对性地加以防治。

Objective To analyse the factors and countermeasures of poor healing on the posterior approach of lumbar operation. Methods We summed up the incidence of poor healing, clinical features, treatment and outcome. Results Primary heating rate was 93.5%, secondary healing rate 5.3%, heahng rate under scar 0.62%. Conclusion The common factors of poor healing are systemic factors, analgesic drug, blood circulatory disorder, fatty and fat necrosis, thermal injury effect ha operation, application of hemostatic drug, biological material and inorganic material, mechanical compression, pulling and suture technique. We should prevent and treat this kind of operation pertinently.