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手术引流对腰椎间盘手术有用吗?

Is Surgical Drain Useful for Lumbar Disc Surgery?

作者信息

Choi Ho Seok, Lee Sang Gu, Kim Woo Kyung, Son Seong, Jeong Tae Seok

机构信息

Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea.

出版信息

Korean J Spine. 2016 Mar;13(1):20-3. doi: 10.14245/kjs.2016.13.1.20. Epub 2016 Mar 31.

Abstract

OBJECTIVE

Surgical drains are commonly used after the spine surgeries for minimizing hematoma formation, which can delay wound healing and may become a source of fibrosis, infection, and pain. The drain, however, may provide a direct route for infection if it is contaminated. Our objective was to survey the relationship between surgical drains and infection.

METHODS

The 70 patients who had undergone single-level lumbar discectomy from April 2011 to March 2012 were retrospectively analyzed. Each patient's medical chart and magnetic resonance image were thoroughly reviewed after all the patients had been divided into the drainage and the nondrainage groups. The amounts and durations of the surgical drains in the drainage group were analyzed. Additionally, the levels of C-reactive protein, rates of infection, scores of preoperative and postoperative visual analog scale (VAS), and lengths of hospital stay after operation were compared between the 2 groups.

RESULTS

In this study, 70 patients were retrospectively analyzed; out of which, 42 and 28 patients were included in the drainage and the nondrainage groups, respectively. Two of the postoperative infection cases in the nondrainage group required to undergo repeated operations. The frequency of the postoperative infection cases was higher in the nondrainage group than in the drainage group; however, there was no significant statistical difference between the 2 groups (p=0.157).

CONCLUSION

Surgical drains did not elevate postoperative infection. Furthermore, drain tip cultures allowed us to detect postoperative infection at an early stage, and it led to faster initiation of antibiotics treatment.

摘要

目的

脊柱手术后通常使用手术引流管以尽量减少血肿形成,血肿会延迟伤口愈合,并可能成为纤维化、感染和疼痛的来源。然而,如果引流管被污染,可能会提供一条直接的感染途径。我们的目的是调查手术引流管与感染之间的关系。

方法

回顾性分析2011年4月至2012年3月期间接受单节段腰椎间盘切除术的70例患者。在将所有患者分为引流组和非引流组后,对每位患者的病历和磁共振图像进行了全面审查。分析了引流组手术引流管的量和持续时间。此外,比较了两组患者的C反应蛋白水平、感染率、术前和术后视觉模拟量表(VAS)评分以及术后住院时间。

结果

本研究对70例患者进行了回顾性分析;其中,引流组和非引流组分别纳入42例和28例患者。非引流组中有2例术后感染病例需要再次手术。非引流组术后感染病例的发生率高于引流组;然而,两组之间无显著统计学差异(p=0.157)。

结论

手术引流管不会增加术后感染率。此外,引流管尖端培养使我们能够在早期检测到术后感染,并能更快地开始抗生素治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e12/4844656/8ffa5a5ab298/kjs-13-20-g001.jpg

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