TLIF术后隐性失血情况及影响因素分析

Analysis of hidden blood loss and influencing factors after TLIF

目的 探讨经椎间孔入路腰椎椎体间融合术(transforaminal lumbar interbody fusion,TLIF)后隐性失血情况,调查隐性失血的影响因素。方法 选取2019年1月~2021年1月我院收治的75例腰椎退行性疾病患者,均采用TLIF术治疗。参照Gross方程计算术后的隐性失血量,分析不同年龄、融合节段、合并疾病患者间的隐性失血量差异,并经多元线性回归分析调查TLIF术后隐性失血量的影响因素。结果 75例患者TLIF术后隐性失血量为(250.89±44.30)mL;不同年龄、手术时间、融合节段数、骨密度T值患者以及是否自体血回输、合并高血脂、糖尿病患者的隐性失血量差异有统计学意义(P<0.05);多元线性回归分析显示,年龄、手术时间、融合节段数、自体血回输、合并高血脂是TLIF术后隐性失血量的影响因素,(P<0.05)。结论 腰椎退行性疾病患者采用TLIF术治疗,术后存在一定程度的隐性失血,影响因素包括年龄、手术时间、融合节段数等。

Objective To investigate the occult blood loss after transforaminal lumbar interbody fusion(TLIF),and investigate the influencing factors of the occult blood loss.Methods From January 2019 to January 2021,75 patients with degenerative diseases of the lumbar spine in our hospital were selected,and all of them were treated with TLIF.According to the Gross equation,the hidden blood loss after surgery was calculated,and the differences in the hidden blood loss among patients of different ages,fusion segments,and comorbid diseases were analyzed.And through multiple linear regression analysis,the influencing factors of hidden blood loss after TLIF were investigated.Results The hidden blood loss after TLIF in 75 patients was(250.89±44.30)mL.There were statistically significant differences in hidden blood loss in patients with different ages,operation time,number of fusion segments,bone mineral density T value,autologous blood transfusion,hyperlipidemia and diabetes(P<0.05).Multiple linear regression analysis showed that age,operation time,number of fusion segments,autologous blood transfusion,and hyperlipidemia were the influencing factors of hidden blood loss after TLIF(P<0.05).Conclusion Patients with lumbar degenerative diseases have a certain degree of hidden blood loss after TLIF surgery.The influencing factors include age,operation time,and number of fusion segments.