腰椎管狭窄症术后应用胶原蛋白海绵减少引流量的对比研究  

Clinical observation of collagen sponge for reducing volume of drainage after surgery for lumbar spinal stenosis

作　　者：卫宏图[1] 田防震[1] 魏彦春[1] 邢宝华[1] 郭丽燕[2] 

机构地区：[1]山东省济宁市第一人民医院骨外一科,272000 [2]济宁医学院流行病学教研室

出　　处：《中国医师进修杂志》2011年第26期1-3,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的观察胶原蛋白海绵在腰椎管狭窄症术后减少引流量的作用。方法因腰椎管狭窄症行腰椎管扩大减压、椎间植骨融合术患者186例，按照随机数字表法将患者分为改进组和对照组。改进组96例患者术后硬膜后放置胶原蛋白海绵；对照组90例患者术后使用传统止血方法止血，未放置胶原蛋白海绵。术后均放置引流管。观察比较两组术后1、12、24h引流量，术前与术后48h血常规的变化，术中及术后48h输血量及输血率等。结果与对照组比较，改进组术后1、12、24h引流量均明显减少[分别为（106．11±20．02）ml比（127．02±25．09）ml、（236．12±34．06）ml比（327．31±51．21）ml、（355．16±49．03）ml比（506．36±85．29）m1]，差异有统计学意义（P〈0．05）。改进组输血量为（176．27±21．37）ml，输血率为10．42％（10／96），均较对照组[（445．94±24．56）ml、32．22％（29／90）]显著减少（P〈0．05）。改进组术后48h红细胞计数为（2．96±0．45）×10^12／L、血红蛋白为（106．75±7．30）g／L，均高于对照组[（2．35±0．57）×10^12／L、（90．45±5．10）g／L]（P〈0．05）。结论胶原蛋白海绵在腰椎管狭窄症术后应用能快速、有效、持久地止血及减少脑脊液渗漏，是减少术后引流量的有效、经济手段。Objective To observe the effectiveness of collagen sponge for reducing volume of drainage after surgery for lumbar spinal stenosis. Methods One hundred and eighty-six patients who suffered from lumbar spinal stenosis were divided into two groups by random digits table method. The test group （96 cases） used collagen sponge to cover dura mater before placing drainage tube,the control group （90 cases） was treated without collagen sponge. The volume of drainage at 1,12,24 h after surgery were observed, the blood routine test was carried out at before and 48 h after surgery and the volume and ratio of blood transfusion after surgery was also measured and compared between the two groups. Results The volume of drainage were significantly decreased in the test group compared with the control group at 1,12,24 h after surgery [（106.11±20.02） ml vs.（127.02 ±25.09） ml, （236.12 ±34.06） ml vs. （327.31±51.21） ml, （355.16 ± 49.03） ml vs.（506.36±85.29） ml]（P〈 0.05）. The volume and the ratio of blood transfusion in the test group were （ 176.27 ± 21.37） ml and 10.42%（10/96） ,which were greatly lower than those in the control group [（445.94 224.56） ml and 32.22% （29/90）] （P 〈0.05）. The number of RBC and the concentration of Hb were （2.96 ± 0.45 ） ×10^12/L and （ 106.75 ± 7.30） g/L, differently in the test group at 48 h after surgery, which were increased significantly compared with the control group [ （2.35± 0.57） ×10^12/L and （90.45 ±5.10） g/L ] （P 〈 0.05 ）. Conclusions Collagen sponge provides rapid, effective and durable hemostasis and decreases the leak of eerebrospinal fluid after surgery for lumbar spinal stenosis. It can be used as an effective and economic method to reduce the volume of drainage after surgery.

关 键 词：椎管狭窄 胶原蛋白海绵 引流 

分 类 号：R687.3[医药卫生—骨科学]