皮下负压引流和可吸收缝线在预防颅骨修补术后并发症中的效果分析  

Effect of subcutaneous negative pressure drainage and absorbable suture on prevention of postoperative complications of cranioplasty

作　　者：张文生[1] 孙雷涛[1] 李泽福[1] 李勐[1] 杜德勇[1] Zhang Wensheng;Sun Leitao;Li Zefu;Li Meng;Du Deyong(Department of Neurosurgery, the Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong 256603, China)

机构地区：[1]滨州医学院附属医院神经外科,山东省256603

出　　处：《中国基层医药》2019年第10期1153-1156,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：山东省自然科学基金项目(ZR2018LH007).

摘　　要：目的探讨皮下负压引流和可吸收缝线在预防颅骨修补术后并发症中的临床效果。方法回顾性分析滨州医学院附属医院神经外科2012年1月至2018年2月收治的颅骨缺损患者175例的临床资料,依据术中处理方式的不同分为术中用丝线缝合帽状腱膜同时行普通引流组(普通引流组)97例和可吸收缝线缝合帽状腱膜同时行负压引流组(负压引流组)78例,丝线和可吸收缝线缝合帽状腱膜均为间断缝合,引流管放在皮下金属钛板外面,术后48~72 h拔除。比较两组术后并发症发生情况。结果负压引流组皮下积液积血、线结反应、切口感染发生率分别为1.3%(1/78)、0.0%(0/78)、0.0%(0/78),均显著低于普通引流组的11.3%(11/97)、20.6%(20/97)、7.2%(7/97),差异均有统计学意义(χ^2=6.85、18.16、4.13,均P<0.05)。结论颅骨修补术中应用可吸收缝线缝合帽状腱膜同时皮下负压引流可以明显减少和预防颅骨修补术后并发症。Objective To explore the therapeutic effect of subcutaneous negative pressure drainage and absorbable suture in preventing postoperative complications of cranioplasty. Methods The clinical data of 175 cases of skull defect admitted and treated in Department of Neurosurgeryof the Affiliated Hospital of Binzhou Medical University from January 2012 to February 2018 were retrospectively analyzed.According to the different intraoperative treatment methods, 97 cases were treated with thread suture to the galea aponeurotica combined with general drainage(the general drainage group), and 78 cases were treated with absorbable suture to the galea aponeurotica combined with negative pressure drainage(the negative pressure drainage group). The galea aponeurotica were sutured intermittently with both silk thread and absorbable suture, and the drainage tube was placed outside the metal titanium plate under the skin, and removed after 48-72 hours.The postoperative complications of the two groups were compared. Results The incidence rates of subcutaneous hemorrhage, knotting reaction, infection of incision in the negative pressure drainage group were 1.3%(1/78), 0.0%(0/78), and 0.0%(0/78), respectively, which were significantly lower than those in the average drainage group[11.3%(11/97), 20.6%(20/97), 7.2%(7/97)], the differences were statistically significant(χ^2=6.85, 18.16, 4.13, all P<0.05). Conclusion The application of absorbable suture suturing galea aponeurotica and subcutaneous negative pressure drainage in skull repair can significantly reduce and prevent postoperative complications of cranioplasty.

关 键 词：负压伤口疗法 引流术 颅骨缺损 颅骨修补术 手术后并发症 

分 类 号：R651.1[医药卫生—外科学]