CT引导微创注射生物蛋白胶治疗骶管囊肿围手术期异常事件的防治  

Peri-operative abmormal events during CT guided percutaneous fibrin glue treatment of sacral cyst

作　　者：吴宏斌[1] 邵增务[1] 杨述华[1] 郑启新[1] 柳曦[2] 

机构地区：[1]华中科技大学附属协和医院骨科,湖北武汉430022 [2]华中科技大学附属协和医院放射科,湖北武汉430022

出　　处：《颈腰痛杂志》2008年第5期421-424,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨CT引导微创注射生物蛋白胶治疗骶管囊肿围手术期异常事件产生的原因,提出防治措施。方法2006年1月-2007年10月行CT引导微创注射生物蛋白胶治疗骶管囊肿37例,其中L5S17例,S1-212例,S2-318例。回顾分析围手术期出现的异常事件和产生的原因。结果血性囊液13例,抽不出囊液4例,骶管内积气28例,骶神经根刺伤2例,术后发热8例,剧烈头痛,呕吐3例,症状无缓解3例,除骶管内积气外,上述并发症多发生于该微创技术早期应用的病例中,与术中穿刺和抽液技术,病例选择不当有关。结论CT导向下的穿刺和抽液技术有一个学习和熟练的过程,掌握技巧,正确选择病例和完善围手术期处理是防治围手术期异常事件的关键。Objective To explore the reason of pert-operative abnormal events during CT guided percutaneous fibrin glue treatment of sacral cyst,bring forward methods to prevent or treat these abnormal events. Methods 37 patients of sacral cysts were treated with CT guided percutaneous fibrin glue treatment of sacral cyst from Jan,2006 to Oct,2007. Location of cyst consisted of 7 L5S1,12 S1-2 and 18 S2-3. Retro-analysis of pert-operative abnormal events such as bloody cystic fluid,no fluid during aspiration,post operative headache and vomit etc. were happened. Results 13 cases had bloody cystic fluid,4 cases aspirated no cystic fluid,28 cases had air leaked into cyst. 2 cases had sacral nerve irritation,3 cases had no improvement of symptoms. Except for air leak,most of the abnormal events occurred at the early time of this treatment. Conclusion There is a learning curve for the puncture and aspiration techninque of CT-guided fibrin glue treatment for sacral cyst. Good technique,proper selection of patient and proper pert-operative treatment are very important for prevention and treatment of pert-operative abnormal events.

关 键 词：微创手术 骶管囊肿 CT 并发症 

分 类 号：R686.7[医药卫生—骨科学] R738.5[医药卫生—外科学]