Ge Zhilin, Zhao Wenhua, Wu Zhihua, He Jiahui, Zhu Guangye, Song Zefeng, Cui Jianchao, Jiang Xiaobing, Yu Weibo
First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
J Pers Med. 2023 Apr 17;13(4):674. doi: 10.3390/jpm13040674.
Full endoscopic lumbar interbody fusion (Endo-LIF) is a representative recent emerging minimally invasive operation. The hidden blood loss (HBL) in an Endo-LIF procedure and its possible risk factors are still unclear.
The blood loss (TBL) was calculated by Gross formula. Sex, age, BMI, hypertension, diabetes, ASA classification, fusion levels, surgical approach type, surgery time, preoperative RBC, HGB, Hct, PT, INR, APTT, Fg, postoperative mean arterial pressure, postoperative heart rate, Intraoperative blood loss (IBL), patient blood volume were included to investigate the possible risk factors by correlation analysis and multiple linear regression between variables and HBL.
Ninety-six patients (23 males, 73 females) who underwent Endo-LIF were retrospective analyzed in this study. The HBL was 240.11 (65.51, 460.31) mL (median [interquartile range]). Fusion levels ( = 0.002), age ( = 0.003), hypertension ( = 0.000), IBL ( = 0.012), PT ( = 0.016), preoperative HBG ( = 0.037) were the possible risk factors.
Fusion levels, younger age, hypertension, prolonged PT, preoperative HBG are possible risk factors of HBL in an Endo-LIF procedure. More attention should be paid especially in multi-level minimally invasive surgery. The increase of fusion levels will lead to a considerable HBL.
全内镜下腰椎椎间融合术（Endo-LIF）是近年来新兴的具有代表性的微创手术。Endo-LIF手术中的隐性失血（HBL）及其可能的危险因素仍不明确。
采用Gross公式计算失血量（TBL）。纳入性别、年龄、体重指数、高血压、糖尿病、美国麻醉医师协会（ASA）分级、融合节段、手术入路类型、手术时间、术前红细胞计数（RBC）、血红蛋白（HGB）、血细胞比容（Hct）、凝血酶原时间（PT）、国际标准化比值（INR）、活化部分凝血活酶时间（APTT）、纤维蛋白原（Fg）、术后平均动脉压、术后心率、术中失血量（IBL）、患者血容量，通过变量与HBL之间的相关性分析和多元线性回归研究可能的危险因素。
本研究回顾性分析了96例行Endo-LIF手术的患者（23例男性，73例女性）。HBL为240.11（65.51，460.31）mL（中位数[四分位数间距]）。融合节段（P = 0.002）、年龄（P = 0.003）、高血压（P = 0.000）、IBL（P = 0.012）、PT（P = 0.016）、术前HBG（P = 0.037）是可能的危险因素（此处原文中“ = ”应是“P = ”，翻译时修正）。
融合节段、年轻、高血压、PT延长、术前HBG是Endo-LIF手术中HBL的可能危险因素。尤其在多节段微创手术中应给予更多关注。融合节段的增加会导致相当多的HBL。
