自制枪状钛夹钳在经蝶手术中的应用  

Clinical application of a new titanium clip applier in transsphenoidal surgery

作　　者：洪远[1] 尹思远[1] 吴群[1] 虞军[1] 张建民[1] 

机构地区：[1]浙江大学医学院附属第二医院神经外科,杭州310009

出　　处：《中华医学杂志》2013年第25期2004-2006,共3页National Medical Journal of China

基　　金：浙江省科技厅面上项目（2009C33023）

摘　　要：目的 研制一种经蝶手术时能有效处理海绵间窦出血和硬脑膜反折处脑脊液漏的手术器械,并评估其在临床实践中的应用效果和安全性.方法 采用钛合金材料,制成工作长度为21cm、前段呈直角的枪状钛夹钳.将此枪状钛夹钳应用在34例垂体腺瘤经蝶手术中,并对手术患者进行24个月随访,术后3 ～18个月做X线及MRI检查,示钛夹位置良好且无明显伪影发生.结果 自制枪状钛夹钳术中使用方便有效,34例手术灾闭海绵间窦出血或硬脑膜反折处脑脊液漏获得成功,无迟发性出血或脑脊液漏再次发生,随访结果亦无钛夹相关性并发症发生.结论 自制枪状钛夹钳在经蝶手术中能有效、安全、快速处理海绵间窦的出血和硬脑膜反折处的脑脊液漏.Objective To explore the efficacy and safety of a new titanium clip applier in tramssphenoidal surgery for the A specially devised surgery instrument was developed and effectively applied in the management of intercavernous sinus hemorrhage and cerebrospinal fluid （CSF） leakage in transsphenoidal surgery.Methods A total of 34 consecutive patients with pituiary adenoma underwent transsphenoidal surgery via a new deep pistol-shaped clip applier versus titanium clip.It was 21 cm long with a rectangular forepart.All patients were evaluated clinically and radiologically at 24 months and magnetic resonance imaging （MRI） was performed at Months 3-18 postoperation.Results The application of such a new clip applier was effective.No operation was terminated due to ineffective hemorrhagic control or CSF leakage management.None of them had clinical symptoms of delayed hemorrhage,postoperative CSF leakage or related complications.Postoperative imaging studies revealed no significant evidence of clip artifact.Conclusion The technique of hemostasis and leakage clogging with such a new clip applier is safer,faster and more reliable than its conventional counterpart in achieving dural closure and intercavernous sinus hemostasis.

关 键 词：手术器械 经蝶入路手术 并发症 转化医学 

分 类 号：R651.1[医药卫生—外科学]