PLIF手术隐性失血危险因素分析

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Abstract Objective To analyze the correlation between the hidden blood loss and perioperative factors in patients received PLIF.Methods We retrospectively analyzed 94 patients underwent PLIF surgery.There were 49 males and 45 females，aged 40~80 years，with an average of 60.8 years old.There were 36 cases of lumbar disc herniation，46 cases of lumbar spinal stenosis，12 cases of lumbar spondylolisthesis，including 61 cases of single-segment surgery and 33 cases of double-segment surgery.And there were 54 elderly patients and 42 overweighted patients.The date were grouped according to perioperative factors such as gender，age，BMI，surgery level and operation time.And we evaluated the influence of perioperative factors on hidden blood loss.Results The operation time was(137.92±43.85)min，and the operation time of 59 cases was more than 120 min.The average perioperative total blood loss was(1 274.65±318.43)mL，with dominant blood loss of(746.44±118.62)mL，recessive blood loss of(529.47±189.53)mL.The recessive blood loss accounted for 41.38% of total blood loss.The single factor analysis showed the differences of hidden blood loss were statistically significant between different surgery level groups and different surgery time groups(P＜0.01).Multivariate linear regression model showed surgery level was an independent risk factor influencing the hidden blood loss.The hidden blood loss in single level surgery group was significantly less than double levels surgery group(P＜0.01).However，no obvious difference in ratio of hidden blood loss to total blood loss was observed(P＞0.05).Conclusion Surgery levels is one of the independent factors affected hidden blood loss in patients received PLIF.More surgery time may associate with more hidden blood loss.

Key words： posterior lumbar fusion hidden blood loss risk factors

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