可吸收止血流体明胶在神经内镜下经鼻蝶入路垂体腺瘤切除术中的应用价值分析  

Application of absorbable Surgiflo haemostatic matrix in endoscopic transsphenoidal pituitary adenomectomy

作　　者：何东升[1] 王宗明[1] 毛志钢[1] 

机构地区：[1]中山大学附属第一医院神经外科,广州510080

出　　处：《中华神经医学杂志》2016年第11期1164-1166,共3页Chinese Journal of Neuromedicine

基　　金：广东省科技计划项目（2014A0202122076）

摘　　要：目的观察可吸收止血流体明胶（商品名Surgiflo，简称流体明胶）在神经内镜下经鼻蝶入路垂体腺瘤切除术中的止血效果。方法中山大学附属第一医院神经外科自2016年1月至2016年6月应用流体明胶治疗神经内镜下垂体腺瘤切除术中出血患者40例．其中16例瘤腔出血，24例海绵窦／海绵间窦出血；出血程度：2级出血10例，3级出血21例，4级出血9例。回顾性分析患者的临床资料和疗效。结果2级及3级出血患者使用流体明胶止血成功，4级出血患者中5例单纯使用流体明胶止血成功，另外4例应用流体明胶结合电凝、骨蜡、止血纱止血成功；2级、3级、4级出血患者流体明胶平均喷涂次数分别为1、1．5、2．5次；全部患者术后复查CT均未见瘤腔及海绵窦／海绵间窦部位积血，随访1个月均未见相关不良反应。结论流体明胶在神经内镜下经鼻蝶垂体腺瘤切除术中具有良好的止血效果，适用于瘤腔出血及海绵窦、海绵间窦出血。Objective To observe the hemostatic efficacy of absorbable Surgiflo haemosatic matrix （trade name： Surgiflo） in endoscopic transsphenoidal pituitary adenomectomy. Methods A total of 40 patients performed endoscopic transsphenoidal pituitary adenomectomy in our hospital from January 2016 to June 2016, were recruited in our study; 16 had tumor cavity bleeding and 24 had cavernous sinus/intercaveruous sinus bleeding; 10 patients had Grade 2 bleeding, 21 Grade 3 bleeding, 9 Grade 4 bleeding and none had Grade 5 bleeding. Surgiflo was used during the surgery. The clinical data and hemostatic efficacy of these patients were retrospectively analyzed. Results In 40 patients, 36 patients achieved haemostasis only by Surgiflo and 4 by Surgiflo with electrocoaulation, bone wax, and hemostatic gauze. Patients with Grade 2, 3 and 4 bleeding had 1, 1.5 and 2.5 times of spray with Surgiflo. Postoperative CT revealed no bleeding. No advance reactions were recorded after one month of follow-up. Conclusion Surgiflo enjoys good, fast and safe haemostasis efficacy in endoscopic transsphenoidal pituitary adenomectomy, which is appropriate to tumor cavity bleeding, cavernous sinus/ intercavernous sinus bleeding in transsphenoidal pituitary adenornectomy.

关 键 词：神经内镜 垂体腺瘤 止血 可吸收止血流体明胶 

分 类 号：R736.4[医药卫生—肿瘤]