退行性腰椎滑脱术后脑脊液漏的发生率及危险因素分析

发布时间：2018-02-03 21:42

本文关键词： 腰椎滑脱脑脊液漏发生率危险因素　出处：《基因组学与应用生物学》2017年08期 　论文类型：期刊论文

【摘要】：为了探究不同患者发生脑脊液漏的诱发原因与相关危险因素,为预防临床手术治疗脊椎滑脱后的并发症提供参考,本研究选取2013年1月至2016年7月于重庆市中医院接受骨科腰椎滑脱术的患者214例作为研究对象。根据患者的不同情况进行腰椎后路椎间融合手术(PLIF)或经椎间孔间融合手术(TLIF),于术中与术后观察患者是否发生脑脊液漏。有脑脊液漏并发者归为观察组,共28例;无脑脊液漏并发者为对照组,共186例。收集患者的资料,通过回顾性分析,进行统计学比较。发现,患者年龄超过70岁(OR=2.088,95%CI=1.079~4.286)、有吸烟史(OR=1.774,95%CI=1.321~2.894)、Meyerding分度高(OR=2.617,95%CI=1.032~3.672)是造成患者术后脑脊液漏的危险因素。主要原因为,降低硬脊膜的柔韧性,使硬脊膜厚度变薄;患者术后生活中,因发生硬脊膜内外压快速改变,导致硬脊膜发生破裂,造成脑脊液漏。滑脱病程时间与患者术后发生脑脊液漏相关,但无显著影响。
[Abstract]:In order to explore the causes and related risk factors of cerebrospinal fluid leakage in different patients, and to provide reference for the prevention of complications after spinal spondylolisthesis. From January 2013 to July 2016, 214 cases of lumbar spondylolisthesis in the department of orthopaedics were selected as the study subjects. The posterior lumbar intervertebral fusion hand was performed according to the different conditions of the patients. Technique (. PLIF or transforaminal fusion surgery (TLIFs). Cerebrospinal fluid leakage was observed during and after operation. 28 patients with cerebrospinal fluid leakage were classified as observation group. The patients without cerebrospinal fluid leakage were the control group (186 cases). The data of the patients were collected and compared statistically by retrospective analysis. The results showed that the patients were over 70 years old. I have a history of smoking 1.774 / 95 / 1.321 / 2.894). The risk factors of cerebrospinal fluid leakage after operation were 2.61795% (Meyerding) and 1.032 (3.672). The main reasons were as follows. Reduce the flexibility of dural, make the thickness of dural thin; In the postoperative life, the dural rupture occurred due to the rapid change of internal and external dural pressure, resulting in cerebrospinal fluid leakage. The duration of spondylolisthesis was correlated with cerebrospinal fluid leakage after operation, but had no significant effect.
【作者单位】：重庆市中医院;
【基金】：重庆市中医院资助
【分类号】：R687.3
【正文快照】： *通讯作者,cz4010@163.comAnalysis of the Incidence and Risk Factors of Cerebrospinal Fluid Leakageafter Degenerative Spondylolisthesis OperationChen Zhi*Cai MingChongqing Traditional Chinese Medicine Hospital,Chongqing,400010*Corresponding author,cz4010@1

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