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叶一,蒋国强,卢斌,罗科锋,岳兵,陆继业,叶志方,宋焕军.基于Caprini风险评估模型的腰椎椎管减压内固定术术后静脉血栓分级预防[J].脊柱外科杂志,2018,16(3):148-151.
基于Caprini风险评估模型的腰椎椎管减压内固定术术后静脉血栓分级预防     点此下载全文 (Fulltext)
叶一  蒋国强  卢斌  罗科锋  岳兵  陆继业  叶志方  宋焕军
宁波大学医学院附属医院脊柱外科, 浙江 315020
基金项目:浙江省医药卫生科技平台重点项目(2014ZDA020)
DOI:10.3969/j.issn.1672-2957.2018.03.005
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摘要:
      目的 探讨后路腰椎椎管减压内固定术术后静脉血栓分级预防的必要性、有效性及安全性。方法 对2011年4月-2013年11月由同一组术者施行腰椎椎管减压内固定术并获得随访的157例患者资料进行回顾性分析。根据预防方法分为物理预防组和分级预防组。物理预防组共71例,术后常规给予间歇充气加压装置预防血栓;分级预防组共86例,采用Caprini风险评估模型对术前危险因素进行评估,根据静脉血栓栓塞(VTE)风险等级给予分级预防,观察并比较2组术后VTE的发生率。结果 物理预防组患者的术后引流量为(176.25±80.21) mL,分级预防组为(209.15±101.70) mL,2组之间差异有统计学意义(P<0.05)。物理预防组术后VTE的发生率为8.5%(6/71),分级预防组为1.2%(1/86),2组之间比较差异有统计学意义(P<0.05)。结论 基于Caprini风险评估模型的腰椎椎管减压内固定术术后静脉血栓分级预防是安全有效的。
关键词:腰椎  椎管狭窄  脊椎滑脱  减压术,外科  内固定器  手术后并发症  静脉血栓形成
Grading prevention of venous thrombosis after lumbar spinal decompression and internal fxation based on Caprini risk assessment model    Fulltext
YE Yi  JIANG Guo-qiang  LU Bin  LUO Ke-feng  YUE Bing  LU Ji-ye  YE Zhi-fang  SONG Huan-jun
Department of Spinal Surgery, Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, Zhejiang, China
Fund Project:
Abstract:
      Objective To investigate the necessity, effectiveness and safety of venous thrombosis grading prevention after lumbar spinal decompression and internal fixation based on Caprini risk assessment model. Methods The data of 157 patients undergoing lumbar spinal decompression and internal fixation from April 2011 to November 2013, which were performed by the same group of surgeon, were analyzed retrospectively. According to the different methods of prevention, the patients were divided into physical prevention group(71 cases) and grading prevention group(86 cases). Physical prevention group were given routine intermittent pneumatic compression devices to prevent thrombosis. The Caprini risk assessment model was used to evaluate preoperative risk factors, and grading prevention was implemented according to the risk level of venous thromboembolism(VTE) in grading prevention group. The incidence of VTE were compared between the 2 groups. Results The postoperative drainage volume was (176.25±80.21)mL in the physical prevention group and (209.15±101.70)mL in the grading prevention group. There was significant difference between the 2 groups(P<0.05). The incidence of VTE after lumbar spinal decompression and fixation was 8.5%(6/71) in the physical prevention group and 1.2% in the grading prevention group(1/86). The difference between the 2 groups was statistically significant(P<0.05). Conclusion The grading prevention of venous thrombosis after lumbar spinal decompression and fixation based on the Caprini risk assessment model is safe and effective.
Keywords:Lumbar vertebrae  Spinal stenosis  Spondylolysis  Decompression, surgical  Internal fixators  Postoperative complications  Venous thrombosis
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