腰椎后路减压融合术后脑脊液漏的危险因素分析

Risk factors analysis of postoperative cerebrospinal fluid leakage after lumbar posterior decompression fusion

目的探讨腰椎后路减压融合术后脑脊液漏的危险因素。方法选择2018年1月—2019年12月医院收治的240例腰椎后路减压融合术患者为研究对象,调查术后脑脊液漏发生情况,将发生脑脊液漏22例作为病例组,未发生脑脊液漏218例作为对照组。采用单因素分析及多因素Logistic回归分析调查术后脑脊液漏危险因素。结果单因素分析显示,年龄、吸烟史、术后体位不当、病程、术后肺部感染是腰椎后路减压融合术后发生脑脊液漏的相关因素(P<0.05);多因素Logistic回归分析显示,吸烟史、术后肺部感染、年龄>70岁、术后体位不当、病程>1年是腰椎后路减压融合术后发生脑脊液漏的独立危险因素(P<0.05)。结论吸烟史、术后肺部感染、高龄、术后体位不当、病程较长者腰椎后路减压融合术后脑脊液漏风险较高,术后应采取针对性护理措施降低脑脊液漏发生率。

Objective To explore the risk factors of postoperative cerebrospinal fluid leakage after lumbar posterior decompression fusion.Methods To select 240 patients with posterior lumbar spine decompression and fusion operation admitted in the hospital from January 2018 to December 2019 as the research objects to explore the occurrence of postoperative cerebrospinal fluid leakage.The 22 cases of cerebrospinal fluid leakage were took as the case group,218 cases without cerebrospinal fluid leakage were took as the control group.By taking the univariate and multivariate Logistic regression analysis to investigate the risk factors of postoperative cerebrospinal fluid leakage.Results Univariate analysis showed that age,smoking history,improper postoperative posture,course of disease,postoperative lung infection were the related factors of postoperative cerebrospinal fluid leakage after lumbar posterior decompression fusion(P<0.05).Multivariate Logistic regression showed that smoking history,postoperative lung infection,age>70 yrs,improper postoperative posture,course of disease>1 year were the independent risk factors of postoperative cerebrospinal fluid leakage after lumbar posterior decompression fusion(P<0.05).Conclusions The patients with smoking history,postoperative lung infection,aged,improper postoperative position,long course of disease had a high risk of postoperative cerebrospinal fluid leakage after lumbar posterior decompression fusion.The target postoperative preventive measures should be taken to decrease the rate of cerebrospinal fluid leakage.