腰间盘术后下肢深静脉血栓形成的防治

Prevetion and treatment of Low Extremity Deep Venous Thrombosis Following Lumbar discectomy

本文报告6例腰椎间盘术后并发下肢深静脉血栓形成病人,占同期897例腰间盘术后病人的0.7％。作者就该并发症的发病原因、诊断、预防及治疗等方面的问题进行了探讨。认为手术时间过长、出血过多、大量输血及术后长时间应用止血药等因素可诱发下肢深静脉血栓形成。该病处理的基本原则是早期诊断和及时治疗,保守治疗72小时无效,应及时采取手术取栓治疗;手术采用Fogarty导管和驱血带祛除血栓,以恢复下肢深静脉血流,结果疗效满意。

Six cases of low extremity deep venous thrombosis following lumbar spine disestomy were reported. The rate of occurrence of the complication accounted for 0. 7% in a total of 897 cases undergoing lumbar disc operation from 1989 to 1996.The problems of phathogenetic foctors,diagnosis,prevention and treatment of the complication were analyzed. Operation for a long time,transfusion for a large number, bleeding shock and using hemostatics for a long-term may induce the occurrence of the disorder. Early functional exercise after surgery is helpful for the prevention of this complication. It is the essential principle for the disorder to be diagnosed and treated as early as possible. If the condition of the complication does not get well with internal remedys or consvervative treatment for 72h or more. Th'e thrombosis should be extracted with Fogarty tuber and queezed out with the bood expelling belt immediately.