微创经椎间孔及后路腰椎椎间融合术对腰椎滑脱症患者术后隐性失血的影响

Influence of Minimally Invasive Surgery-Transforaminal Lumbar and Posterior Lumbar Interbody Fusion on Postoperative Hidden Blood Loss in Patients with Lumbar Spondylolisthesis

目的：探究微创经椎间孔腰椎间融合术（MIS-TLIF）与后路腰椎椎间融合术（PLIF）对腰椎滑脱症患者术后隐性失血的影响。方法：选取2014年03月~2014年08月腰椎滑脱症患者共48例,其中行MIS-TLIF术治疗患者23例,行PLIF术治疗患者25例,记录两组手术相关指标,及手术前后红细胞平均压积（Hct）,依据Gross循环血量线性方程计算患者失血总量及隐性失血量,比较两组患者术后并发症情况。结果：MIS-TLIF组手术时间长于PLIF组（P〈0.05）,而住院时间明显少于PLIF组（P〈0.05）;MIS-TLIF组患者隐性失血量低于PLIF组（P〈0.05）;MIS-TLIF组术后并发症发生率低于PLIF组（P〈0.05）。结论：与传统PLIF术式相比,MIS-TLIF治疗腰椎滑脱症具有隐性失血少,术后并发症少,恢复快的优点,值得临床推广。

Objective： To explore the influence of minimally invasive surgery-transforaminal lumbar interbody fusion（MIS-TLIF）and posterior lumbar interbody fusion（PLIF） on the postoperative hidden blood loss in patients with lumbar spondylolisthesis. Methods： A total of 48 patients with lumbar spondylolisthesis（23 patients undergoing MIS-TLIF, 25 patients undergoing PLIF）, who were treated in Affiliated Hospital of Binzhou Medical College from March 2014 to August 2014, were selected. The surgery related indexes and the hematocrit（hct） values before and after surgery of the two groups were recorded; the total bleeding volume and hidden blood loss were calculated by the Gross formula;the incidence of complications in the two groups after surgery was compared. Results： The surgery time in MIS-TLIF group was longer than that in PLIF group（P〈0.05）, but the hospital time in MIS-TLIF group was shorter than that in PLIF group（P〈0.05）. The hidden blood loss in MIS-TLIF group was lower than that in PLIF group（P〈0.05）. The incidence of complications in MIS-TLIF group was lower than that in PLIF group（P〈0.05）. Conclusion： Compared with the traditional PLIF in treatment of lumbar spondylolisthesis, MIS-TLIF has the advantages of less hidden blood loss, fewer complications,and faster recovery, which is worthy of promotion in clinical field.