腰椎后路减压内固定融合术后下肢静脉血栓形成与术后发热的相关性研究

The correlation between postoperative fever and lower limb thrombosis following posterior lumbar interbody fusion

目的探讨腰椎后路减压内固定融合术后下肢静脉血栓形成与术后发热的相关性。方法回顾性分析2009-02至2015-05于河北医科大学第三医院脊柱二区接受腰椎后路减压内固定融合手术的982例患者的临床资料,依据术后下肢静脉彩超检查是否发生静脉和/或肌间静脉血栓分为血栓组(存在静脉和/或肌间静脉血栓)和无栓组(未发生血栓)。记录并比较两组年龄、性别、手术时间、手术节段、手术前后的体温(术前1 d、手术当天、术后1～6 d)。结果血栓组共127例患者(血栓发生率为12.9%),无栓组共855例患者。两组患者年龄、性别、手术时间、手术节段的比较,差异均无统计学意义。血栓组与无栓组患者在术前1 d、手术当天、术后1 d、术后4 d、术后5 d、术后6 d体温值比较,差异无统计学意义。血栓组术后2 d和3 d体温值高于无栓组,但差异无统计学意义。结论术后体温值较高所伴随的体液内环境改变对腰椎后路减压固定融合术后下肢静脉血栓形成有一定关联,术后针对患者体温升高的可能因素进行有效控制,对于预防下肢深静脉血栓的形成具有重要的作用。

Objective The objective of this study was to investigate the correlation between postoperative fever and lower limb thrombosis following posterior lumbar interbody fusion （PLIF）. Methods Clinical data of 982 patients undergoing PLIF surgery in the Third Hospital of Hebei Medical University from February 2009 to May 2015 were retrospectively analyzed. The patients were divided into thrombus group （presence of venous and / or muscular venous thrombosis） and non-thrombus group （no thrombosis） according to results of their color Doppler ultrasonography. Their age, gender, operation length, operative segments, body temperature before and after surgery were recorded and compared between the two groups. Results A total of 127 cases （12.9%） fell into thrombus group, and 855 cases into non-thrombosis group. The differences of age, sex, the operation length, and the operative segment between the two groups were of no statistically significance. The differences in body temperature at the time point of 1 d before the operation, the day of operation, 4 d, 5 d, and 6 d after the operation between the two groups were not statistically significant. The body temperatures at the time point of 2 d and 3 d after the operation in the thrombus group were higher than those in the non-thrombus group, and the differences were not statistically significant. Conclusions Postoperative fever combined with the induced environmental changes in the body fluid is a risk factor for thrombus following PLIF. The body temperature should be controlled to prevent the lower limb thrombosis.