微纤维止血胶原在腰椎手术脑脊液漏防治中的应用效果

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英文篇名：Application effect of microfibrillary hemostatic collagen in the prevention and treatment of cerebrospinal fluid leakage in lumbar surgery 作者：刘大朋 ; 张永兴 ; 张海涛 ; 董钊 ; 赵云飞 ; 王磊 英文作者：LIU Da-peng;ZHANG Yong-xing;ZHANG Hai-tao;DONG Zhao;ZHAO Yun-fei;WANG Lei;Spine Surgery Department, the 252nd Hospital of PLA; 关键词：微纤维止血胶原 ; 脑脊液漏 ; 硬脊膜破裂 ; 明胶海绵生物蛋白 英文关键词：microfibrillary hemostatic collagen;;cerebrospinal fluid leakage;;spinal dural rupture;;gelatin sponge bioprotein glue 中文刊名：YLYS 英文刊名：Clinical Research and Practice 机构：解放军二五二医院脊柱外科; 出版日期：2019-01-21 出版单位：临床医学研究与实践 年：2019 期：v.4 语种：中文; 页：YLYS201903023 页数：3 CN：03 ISSN：61-1503/R 分类号：55-56+66

摘要

目的腰椎手术出现硬脊膜破裂后分别采用微纤维止血胶原和明胶海绵生物蛋白胶覆盖方法,比较两种方法防治术后脑脊液漏的效果。方法选择2010年1月至2017年12月行腰椎后路手术伴硬脊膜破裂的45例患者为研究对象,采用明胶海绵喷撒生物蛋白胶覆盖硬脊膜破裂治疗22例(A组),微纤维止血胶原覆盖硬脊膜破裂治疗23例(B组)。观察两组手术相关指标、切口一期愈合及严重并发症发生情况。结果 B组脑脊液漏发生率、早期常见并发症发生率、引流管留置时间、切口愈合时间及住院时间均显著优于A组,差异具有统计学意义(P<0.05)。两组严重并发症发生率无显著差异(P>0.05)。结论微纤维止血胶原覆盖硬脊膜有利于保持硬脊膜完整性,其预防及治疗腰椎术后脑脊液漏的效果优于明胶海绵生物蛋白胶方法,且并发症少,值得临床推广应用。
        Objective Microfibrillary hemostatic collagen and gelatin sponge bio-protein glue were used to cover spinal dural rupture after lumbar surgery, the effects of two methods in the prerention and treatment of cerebrospinal fluid leakage after operation were compared. Methods From January 2010 to December 2017, 45 patients who underwent posterior lumbar surgery with dural rupture were selected as the study objects. A total of 22 patients were treated with gelatin sponge spraying bio-protein glue to cover spinal dural rupture(group A), and 23 patients were treated with microfibrillar hemostatic collagen to cover spinal dural rupture(group B). The operation-related indexes, primary healing of incision and serious complications were observed in the two groups. Results The incidences of cerebrospinal fluid leakage and early common complications,indwelling time of drainage tube, wound healing time and hospitalization time in the group B were significantly better than those in the group A, the differences were statistically significant(P <0.05). There was no significant difference in the incidences of severe complications between the two groups(P>0.05). Conclusion Microfibrillary hemostatic collagen to cover the spinal dural rupture is conducive to maintaining spinal dural integrity, has better prevention and treatment effect of cerebrospinal fluid leakage after lumbar surgery than gelatin sponge bio-protein glue, with fewer complications. It is worthy of clinical promotion and application.

引文

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