深筋膜层连续严密缝合与间断缝合防治腰椎后路手术后脑脊液漏的对比研究  

Effect comparison between cerebrospinal fluid leakage using various deep fascia continuous suture techniques and interrupted suture in lumbar posterior surgery

作　　者：王军[1] 郑守超[1] 刘晓慧[2] 郜顺兴[1] 田伟荣[1] 韩庆林[3] 

机构地区：[1]河北省沧州中西医结合医院骨二科,河北沧州061000 [2]河北省沧州中西医结合医院口腔科,河北沧州061000 [3]河北省沧州中西医结合医院心理科,河北沧州061000

出　　处：《实用临床医药杂志》2017年第24期30-33,共4页Journal of Clinical Medicine in Practice

基　　金：河北省医学科学研究重点课题计划项目(20171185)

摘　　要：目的探讨深筋膜层连续严密缝合与间断缝合防治腰椎后路手术后脑脊液漏的疗效差异。方法本研究回顾性分析本院行腰椎后路手术的病例,术后出现脑脊液漏39例,其中22例术中采用连续缝合法关闭腰背深筋膜(A组),17例术中采用间断缝合法关闭腰背深筋膜(B组)。对2组患者的术后平均拔管时间、下地时间、伤口愈合时间以及术后不同时间的VAS评分进行记录并对比分析。结果连续缝合组拔管时间、下地时间、伤口愈合时间优于间断缝合组。连续缝合组术后第1、3、7、14天的VAS平均评分分别为3.55、2.64、1.18、0.36分,间断缝合组术后第1、3、7、14天的VAS平均评分分别为3.35、4.18、2.18、0.59分,连续缝合组第3天和第7天的VAS评分优于间断缝合组,但第1天和第14天差异无统计学意义。结论相比深筋膜层间断缝合,深筋膜层连续严密缝合防治腰椎后路术脑脊液漏的临床效果更好。Objective To compare clinical effects on treatment of cerebrospinal fluid leakage using various deep fascia suture techniques in lumbar posterior surgery. Methods There were 39 cases with cerebrospinal fluid leakage after lumbar posterior surgery in our hospital, in whom 22 cases were treated with deep fascia continuous suture, and 17 cases were treated with deep fascia interrupted suture. The extubation time, ambulation time, healing time and VAS scores in different times were recorded. Results The average extubation time, ambulation time, healing time of continuous suture group were better than that in interrupted suture group. The VAS scores on 1, 3, 7, 14 d after operation in the continuous suture group was 3.55, 2.64, 1.18, 0.36, and were 3.35,4.18, 2.18, 0.59 in the interrupted suture group. There were statistically significant differences in VAS scores on 3, 7 d after operation between continuous suture group and interrupted suture group, while no significant differences were found in VAS scores on 1, 14 d after operation. Conclusion Deep fascia continuous suture method has better effect on the treatment of cerebrospinal fluid leakage after lumbar posterior surgery.

关 键 词：深筋膜层 连续严密缝合 间断缝合 腰椎后路手术 脑脊液漏 

分 类 号：R765.24[医药卫生—耳鼻咽喉科]