负压引流在单侧TLIF治疗单节段腰椎退行性疾病的有效性探讨

Exploration of the effectiveness of negative pressure drainage in the treatment of single level lumbar degenerative disease with unilateral transforaminal lumbar interbody fusion

目的探讨负压引流在单侧TLIF治疗腰椎退行性疾病中的有效性,及术后是否必须使用负压引流。方法回顾性分析本组2008-02-2013-01诊治的136例单侧TLIF治疗腰椎退行性疾病病例,其中70例术后留置负压引流,66例未予负压引流,分析对比两组在术后伤口感染、输血、硬膜外血肿、发热(术后第一天口腔温度>380C)、血红蛋白以及术后3月ODI评分。结果在术后留置负压引流组和未予负压引流组中,均未发现术后伤口感染和硬膜外血肿,两组病例均未输血;术后发热率分别为70%和53%,P<0.05;术后血红蛋白分别为9.31±0.60 g/dL和10.45±0.93 g/dL,P<0.05;术后3月ODI评分分别为12±2.50分和11.85±2.49分,P>0.05。结论单侧TLIF治疗腰椎退行性疾病时,术后不留置负压引流并不会增加伤口感染和硬膜外血肿的发生率,能减少术后发热的几率,减轻术后贫血,手术效果较留置负压引流者无明显差别。

Objective To explore the effectiveness of negative pressure drainage in the treat- ment of single-level lumbar degenerative disease with unilateral transforaminal lumbar interbody fu- sion （TLIF）,and whether the negative pressure drainage must be used after the surgery. Methods From February 2008 to January 2013,retrospective study about the treatment results of single-level lumbar degenerative disease with unilateral TLIF was done in 136 cases. Among them,70 cases were indwelled with negative pressure drainage,66 cases were not. The postoperative wound infec- tion,blood transfusion,epidural hematoma,hemoglobin and oswestry disability index （ODD score were compared between the two groups. Results There were no wound infection,blood transfusion or epidural hematoma in the two groups. The incidence rate of postoperative fever was 70% and 53% respectively （P〈0.05）. Postoperative hemoglobin was（9.31_＋0.60）g/dL and （10.45-＋0.93）g/dL,respec- tively （P〈0.05）.ODI score postoperative 3 months was （12_＋2.50） and （ll.85_＋2.49）,respectively （P〉0.05）. Conclusion When single level lumbar degenerative disease was treated with unilateral TLIF without drainge postoperatively,it will not increase the incidence of wound infection or epidu- ral hematoma, but the incidence rate of postoperative fever can be reduced and anemia is alleviat- ed. There is no obvious difference in surgical outcome between patients with or without drainage.