腰椎术后切口积液的探讨Study of postoperative incisal effusion following posterior lumbar spinal surgery
胡飞;尚希福;孔荣;方诗元;童元;
摘要(Abstract)：
[目的]分析后侧入路腰椎术后切口积液产生的原因,探讨积液的分型并确定相应的治疗策略。[方法]自2001年6月~2006年6月本院共开展1986例经后侧入路的腰椎手术。使用内固定的手术877例,未使用内固定手术1109例,比较两组间切口积液的发生率。将发生积液的病人分为Ⅲ型:Ⅰ型:病因明确型,共28例;Ⅱ型:感染型,共11例;Ⅲ型:病因不明确型,共14例。Ⅰ型病人给予穿刺抽液,对因治疗,营养疗法。Ⅱ型病人给予穿刺抽液,清创,手术灌洗和按药敏给予抗生菌治疗。Ⅲ型病人给予穿刺和预防应用抗生素。[结果]使用内固定组的切口积液率(4·33%)高于未使用内固定组(1·35%)P<0·01。平均住院日:Ⅰ型14·7d,Ⅱ型:87·6d,Ⅲ型:15·6d。[结论]伴随手术过程的复杂化切口积液率明显增高。给积液分型有助于确定有效的治疗方案。Ⅰ型病人予以穿刺抽液和对因治疗。Ⅲ型治疗的关键是防止转化为Ⅱ型。Ⅱ型治疗比较困难,积极的手术干预和按药敏给予抗生菌是两个关键的治疗方法。
关键词(KeyWords)： 腰椎手术;术后并发症;切口积液;感染
基金项目(Foundation):
作者(Author): 胡飞;尚希福;孔荣;方诗元;童元;
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DOI:
参考文献(References)：
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