集束化防护措施对老年人腰椎间盘突出行椎间孔镜手术后感染的疗效

Therapeutic effect of cluster protection measures on postoperative infection in elderly lumbar disc herniation patients treated with intervertebral foramen mirror surgery

目的探讨集束化防护措施对老年人腰椎间盘突出症行椎间孔镜手术后感染的疗效。方法选取2018年1月至2019年12月在我院进行手术的98例腰椎间盘突出老年患者作为研究对象,随机分为干预组49例和常规组49例,给予相应的防护措施;干预组给予集束化防护措施,对照组给予常规措施,比较两组患者术后感染率及术后相关指标的差异。结果对照组49例患者发生肺部感染3例(6.12%)、上呼吸道感染2例(4.08%)、泌尿系统感染2例(4.08%)、伤口感染1例(2.04%),感染率为16.33%(8/49);干预组49例患者发生肺部感染1例(2.04%)、上呼吸道感染1例(2.04%)、无泌尿系统和伤口感染,感染率为4.08%(2/49);对照组感染率高于干预组(χ^2=4.009,P=0.045)。干预组49例患者手术时间(30.4±1.1)min、下床活动时间(1.6±0.7)d、住院天数(4.3±0.6)d、手术出血量(54.8±7.3)ml,少于对照组患者手术时间(101.9±51.1)min、下床活动时间(3.7±1.2)d、住院天数(13.2±3.8)d、手术出血量(142.7±69.6)ml(t=9.759、10.193、15.789、8.780,均P=0.000)。结论与常规措施比较,集束化防护措施能确保围术期安全,使手术时间短、出血少、下床活动时间和住院时间缩短,是减轻疼痛、恢复功能的有效方法;经过周密的围术期治疗及防护,减少了术后感染的发生率,降低了并发症的发生率,取得了满意的效果。

Objective To investigate the effect of cluster protection measures on postoperative infection in elderly lumbar disc herniation patients undergoing minimally invasive surgery by using intervertebral foramen mirror surgery.Methods A total of 98 elderly lumbar disc herniation patients treated with the surgery in our hospital were enrolled from January 2018 to December 2019.They were randomized into the intervention group(n=49)receiving cluster protection measures and the routine group(n=49)receiving conventional protection measures.The incidences of infection and related indexes after surgery were compared between the two groups.Results A total infection rate was higher in the routine group[16.33%(8/49)]than in the intervention group[4.08%(2/49)](χ^2=4.009,P=0.045).The operation time,out-of-bed activity time,hospitalization days and surgical blood loss were less in the intervention group than in the routine group[(30.4±1.1)min vs.(101.9±51.1)min,(1.6±0.7)d vs.(3.7±1.2)d,(4.3±0.6)d vs.(13.2±3.8)d,(54.8±7.3)ml vs.(142.7±69.6)ml,t=9.759,10.193,15.789 and 8.780,all P=0.000].Conclusions Compared with the routine prevention measures,the cluster prevention measures can ensure the perioperative safety,shorten the operation time and reduce surgical blood loss,out-of-bed activity time and hospitalization days.Therefore,after careful perioperative treatment and protection,the cluster prevention measures can relieve pain,restore function,reduce the incidences of postoperative infection and complications,and achieve satisfactory nursing results.