腰椎融合术后不同负压引流值产生引流效果的对比研究

A comparative study of different negative pressure drainage values after lumbar fusion

目的探讨两节段腰椎后路全椎板切除减压融合内固定术后创腔内负压引流的压力值范围,以及不同负压引流值对引流效果的影响。方法选取2021年12月—2022年8月于徐州医科大学附属医院行开放性双节段腰椎后路全椎板切除减压融合术的患者共72例。根据术后负压引流值,将患者随机分为A、B、C、D组,每组18例,负压引流值分别为50、100、200、300 mmHg。比较各组一般资料,术中出血量,术后6、12、24、48 h引流量,术前和术后48、72 h血红蛋白值,术后需要输血治疗的患者人数以及切口并发症等。结果各组患者性别、年龄、术中出血量比较,差异无统计学意义(P>0.05)。4组术后6、12 h引流量比较,差异有统计学意义(P<0.05);A组和B组术后24、48 h引流量比较,差异无统计学意义(P>0.05);且分别显著少于C组和D组引流量,差异有统计学意义(P<0.05)。A组术后48 h血红蛋白值与B组比较无统计学差异(P>0.05),但显著高于C组和D组(P<0.05)。A、B组患者中未进行输血治疗,C组和D组输血治疗患者分别为2例和5例。各组术后切口并发症比较,差异无统计学意义(P>0.05)。结论开放性腰椎两节段全椎板切除减压融合内固定患者术后引流装置的负压引流值,建议设置在50~100 mmHg,可明显减少术后引流量和总出血量,降低患者输血概率,加速患者早期恢复。

Objective To explore the proper range of negative pressure drainage value of posterior lumbar fusion,and the effect of different negative pressure drainage values on drainage effect.Methods A total of 72 patients who underwent posterior lumbar fusion in the Affiliated Hospital of Xuzhou Medical University from December 2021 to August 2022 were selected.According to negative pressure drainage values,the patients were randomly divided into groups A,B,C and D(n=18),with the negative pressure drainage values of 50,100,200 and 300 mmHg,respectively.These groups were compared for their general information,introperative blood loss,drainage volumes at postoperative 6 h,12 h,24 h,and 48 h,hemoglobin before surgery and at postoperative 48 h and 72 h,the number of patients requiring blood transfusion and incision complication.Results There were no statistical difference in age,sex,and intraoperative blood loss among the four groups(P>0.05).Each group showed remarkably differences in drainage volume at postoperative 6 h and 12 h(P<0.05).Gronp A and gronp B showed differences in drainage volume at postoperative 24 h and 48 h(P>0.05).The drainage volumes of groups A and B at postoperative 24 h and 48 h were significantly less than those of groups C and D,respectively(P<0.05).Group A presented decreased hemoglobin at postoperative 48 h,compared with groups C and D(P<0.05);without difference in hemoglobin,compared with group B(P>0.05).There were two and five cases of blood transfusion in groups C and D,respectively,and no blood transtusion cases were reported in groups A and B.No statistical difference was found in incision complication among the four groups.Conclusions The negative pressure drainage value of open lumbar postoperative drainage device can be set from 50 to 100 mmHg,which will significantly reduce postoperative drainage volume and total blood loss,and reduce the probability of blood transfusion.