Observation And Analysis Of Related Risk Factors Of Postoperative Drainage After Posterior Lumbar Interbody Fusion

Objective:Posterior lumbar interbody fusion(PLIF) is the most widely used surgical method in the treatment of lumbar degenerative disease. Laminectomy is performed during the surgery and more muscle tissues were deprived, the spinal decompression process may damage the spinal canal and venous plexus, and together with the stimulation of internal fixation, which all of these can cause more postoperative bleeding. Postoperative drainage of PLIF are closely associated with postoperative anemia, wound hematoma,infection and other complications. And how to reduce postoperative blood loss,postoperative drainage and complications is a key problem faced by clinicians. Therefore,the purpose of the study are:1: To identify risk factors associated with PLIF postoperative drainage using the univariate analysis.2: To explore the relationship between the risk factors and PLIF postoperative drainage using the multivariate analysis, making reference to reduce postoperative bleeding and postoperative drainage further.Method:1.Using a retrospective study method to make a statistical analysis about 126 patients who performed PLIF surgery in the Second Hospital of Shanxi Medical University department of orthopedics from January 2014 to January 2015 period..2.Applying the univariate analysis to evaluate the possible risk factors( gender,age, body mass index, type of disease, concomitant disease, intraoperative blood transfusion, intraoperative blood loss, operation segment number, time of operation,drainage pattern) of the lumbar postoperative drainage with the statistical software SPSS17.0,and multivariate logistic regression analysis is further used to explore the risk factors, P <0.05 was considered statistically significant.Results:1. Univariate analysis showed that:(1) Age, operation time, intraoperative blood transfusion, blood loss, the number of segments are statistical significant(P <0.001);(2) Sex, height and weight, comorbidities and postoperative drainage pattern are no statistical significant(P> 0.05).2. Multivariate Logistic regression analysis showed that:(1)Increased risk of postoperative drainage in patients over the age of 60 is 3.722 times of the patients under the age of 60;(2) Increased risk of postoperative drainage in patients whose Intraoperative bleeding more than 800 ml is 7.533 times of the patients less than 400 ml; while it showed no difference in the postoperative blood loss between the patients less than 400 ml and 400-800 ml, and compared the intraoperative blood loss 400-800 ml with more than 800 ml,the result show no significant difference either;(3) Increased risk of postoperative drainage in patients with 3 surgical section and more is 2.047 times of the single one; while 1 segment and 2 segment in patients with postoperative drainage showed no obvious difference, and 2 segments and 3 or more segments in patients of postoperative drainage showed no significant difference either.;(4) The amount of blood transfusion and the operation time showed no significant correlation with the postoperative drainage.Conclusions:1. Age, operation time, intraoperative blood transfusion, intraoperative blood loss,operative segment numbers are relevant to the postoperative drainage.2. The age of patients, intraoperative bleeding volume, number of surgical segment arethe high risk factors of the postoperative drainage.