多节段经椎间孔椎体间融合三种引流方式比较

Comparison of three drainaee methods after multi-seement transforaminal lumbar interbodv fusion

[目的]比较多节段经椎间孔椎体间融合(transforaminal lumbar interbody fusion,TLIF)3种引流方式临床疗效。[方法]2019年7月-2021年6月在本科行TLIF治疗的多节段腰椎退变104例患者采用随机数字表法分为三组,于TLIF术后分别给予3种引流,其中,34例行间断负压引流,37例行持续负压引流,33例行常压引流。比较三组早期及随访结果。[结果]所有患者均顺利完成手术,三组手术时间、术中出血量差异无统计学意义(P>0.05),持续负压组第1 d和术后总引流量,以及引流管留置时间显著大于其他两组(P<0.05);常压组伤口敷料渗血次数显著多于其他两组(P<0.05)。随时间推移。三组患者腿痛VAS评分、ODI评分、JOA评分均显著改善(P<0.05),相应时间点,三组间上述评分的差异均无统计学意义(P>0.05)。[结论]多节段TLIF术后采用间断负压引流可以明显减少引流量和伤口渗血,缩短引流时间,是一种安全有效的方式。

[Objective]To compare the clinical efficacy of three drainage methods after multi-segment transforaminal lumbar interbody fusion(TLIF).[Methods]From July 2019 to June 2020,a total of 104 patients who were undergoing TLIF for multilevel lumbar degenerative diseases in our department were divided into 3 group.After TLIF,34 patients had intermittent negative pressure drainage(INPD),37 patients received continuous negative pressure drainage(CNPD),while the remaining 33 patients were treated by natural pressure drainage(NPD).The perioperative and follow-up data of the three groups were compared.[Results]All the patients in the 3 groups had TLIF performed smoothly.Although there were no significant differences in operative time and intraoperative blood loss among three groups(P>0.05),the CNPD group proved significantly greater than the INPD and NPD groups in terms of drainage volume at the 1^(st)postoperative day,total volume of postoperative drainage and total drainage days(P<0.05).However,the NPD group had significantly greater incision errhysis than the INPD and CNPD groups(P<0.05).The VAS of leg pain and ODI significantly decreased(P<0.05),while the JOA scores significantly increased over time postoperatively in all the 3 groups(P<0.05),whereas which proved not statistically significantly among the 3 groups at any corresponding time points(P>0.05).[Conclusion]The intermittent negative pressure drainage after multilevel TLIF does significantly reduce the drainage volume,reduce postoperative wound bleeding,and shorten total drainage days,is a safe and effective drainage method.