腰椎后路手术后常见并发症的原因分析及预防策略

罗鹏明，姚福东，张军，张国华，王建顺，王新虎

（宝鸡市中心医院脊柱外科，陕西 宝鸡，721008）

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摘要：

目的 分析腰椎后路开放手术常见并发症发生的原因，研究并发症发生的相关因素，探求防治策略，以为后续临床工作 指引方向并提供参考。方法 回顾性分析我院2010年5月至2014 年5 月收治的行腰椎后路手术后发生并发症的796 例患者 的临床资料，患者均依据病史、临床表现及影像学检查后行个性化手术治疗。统计及分析患者术后并发症发生原因。结果对 所有患者进行随访，随访时间6~24 个月，平均13 个月。62 例患者术后出现各类并发症，其中脊髓神经损伤症状24例、感染 8例、内固定失效相关并发症9例、脑脊液漏5 例、消化道症状7 例（应激性溃疡、腹胀便秘）、下肢静脉血栓形成5 例、术后腰 背部慢性疼痛4例。结论 腰椎后路手术是治疗腰椎疾病有效的治疗手段，总体效果良好，但并发症种类较多，主要为神经损伤、内固定失效及感染。术前严格把握适应证、术中规范操作、术后严密观察、及时处理可有效降低并发症发生率。

关键词：腰椎手术；术后并发症；预防策略

中图分类号：R687.3文献标志码：A文章编号：2096-1413(2017)35-0064-02

Causes and prevention strategies of common complications after posterior lumbar surgery
LUO Peng-ming, YAO Fu-dong, ZHANG Jun, ZHANG Guo-hua, WANG Jian-shun, WANG Xin-hu


(Spine Surgery Department, Baoji Central Hospital, Baoji 721008, China)

ABSTRACT: Objective To analyze the causes and the related factors of common complication in open posterior lumbar surgery, explore the prevention and treatment strategies, to provide a reference and guidance for the follow -up clinical work. Methods The clinical data of 796 patients with complications after posterior lumbar surgery in our hospital from May 2010 to May 2014 were retrospectively analyzed, all the patients were treated with personalized surgery based on medical history, clinical manifestations and imaging examination. The causes of postoperative complications in patients were statistically analyzed. Results All the patients were followed up for 6 to 24 months, with an average of 13 months. There were 62 patients showed various complications after operation, including 24 cases of spinal nerve injury, 8 cases of infection, 9 cases of internal fixation failure related complications, 5 cases of cerebrospinal fluid leakage, 7 cases of gastrointestinal symptoms (including stress ulcer, abdominal distension and constipation), 5 cases of lower extremity venous thrombosis, 4 cases of postoperative chronic lower back pain. Conclusion Posterior lumbar surgery is an effective treatment for lumbar disease, which has remarkable overall effect, but it has various complications, mainly complications are nerve injury, internal fixation failure and infection. It can effectively reduce the incidence of complications by strict control of indications before surgery, specification of the operation, close observation and timely treatment.
KEYWORDS: lumbar surgery; postoperative complications; prevention strategies

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