流体明胶SurgifloTM与明胶海绵在腰椎融合手术中止血效果的对比  

Hemorrhage control of fluid gelatin SurgifloTM versus gelatin sponge in lumbar spinefusion surgery

作　　者：覃文聘 杨雨洁 赵来赫 石晓伟 鹿蕾 杨鸿旭 黄景辉[2] Qin Wenpin;Yang Yujie;Zhao Laihe;Shi Xiaowei;Lu Lei;Yang Hongxu;Huang Jinghui(The Cadet Team 5(Regiment),School of Basic Medicine,The Fourth Military Medical University,Xi’an 710032,Shaanxi Province,China;Department of Orthopedics,Xijing Hospital,The Fourth Military Medical University,Xi’an 710032,Shanxi Province,China;State Key Laboratory of Military Stomatology&National Clinical Research Center for Oral Diseases&Shaanxi Key Laboratory of Stomatology,Department of Oral Anatomy and Physiology,School of Stomatology,The Fourth Military Medical University,Xi’an 710032,Shanxi Province,China)

机构地区：[1]解放军第四军医大学基础医学院学员五大队,陕西省西安市710032 [2]解放军第四军医大学西京医院骨科,陕西省西安市710032 [3]军事口腔医学国家重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔疾病国际联合研究中心,解放军第四军医大学口腔医院口腔解剖生理学教研室,陕西省西安市710032

出　　处：《中国组织工程研究》2020年第4期561-565,共5页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81672148)，项目负责人：黄景辉~~

摘　　要：背景:止血是脊柱外科术中最重要的手术环节,目前普遍应用的明胶海绵具有一定的效果,但止血时间长,止血效果不理想,需要探索新的止血方法。目的:比较流体明胶SurgifloTM与普通明胶海绵在腰椎融合手术中的止血效果。方法:纳入解放军第四军医大学西京医院2017年9至12月收治的98例腰椎融合手术患者,其中男52例,女46例,平均年龄54.32岁,所有患者均进行单节段L4/5腰椎融合手术,其中48例应用流体明胶SurgifloTM进行术中止血,50例应用普通明胶海绵进行术中止血。比较两组术中出血量、术后引流量、3min止血成功率、围术期血红蛋白变化等。结果与结论:(1)流体明胶组手术时间短于普通明胶组[(105±26),(118±32) min,P<0.05],术中出血量、术后引流量少于普通明胶组[流体明胶组:(156±57),(106±42) mL;普通明胶组:(204±62),(148±35) mL,P<0.05],3 min止血成功率高于普通明胶组(94%,80%,P<0.05),围术期血红蛋白变化量低于普通明胶组[(12.3±3.6),(22.8±4.3) g/L,P<0.05];(2)两组患者均未发生过敏反应、免疫排斥反应、术后延迟血肿等并发症;(3)结果表明,流体明胶SurgifloTM可显著减少腰椎融合手术的术中出血量及术后引流量,具有更好的止血效果。BACKGROUND: Hemorrhage control has been an important issue in spine surgery. The widely used gelatin sponge is limited by its long-time bleeding control and poor hemorrhage control. Therefore, new techniques are needed to control bleeding in spine surgery. OBJRCTIVE: To compare the hemostatic effect of fluid gelatin SurgifloTM with absorbable gelatin sponge in single level posterior lumbar fusion surgery. METHODS: Ninety-eight patients consisting of 52 males and 46 females, aged 54.32 years who received treatment between September 2017 and December 2017 in Xijing Hospital of The Fourth Military Medical University were included in this study. All patients underwent single-level L4/5 lumbar fusion. Among them, 48 patients received intraoperative hemostasis with fluid gelatin Surgiflo TM and 50 patients recei ved intraoperative hemostasis with conventional gelatin sponge. Intraoperative bleeding volume, postoperative drainage volume, success rate of hemostasis in 3 minutes and changes of hemoglobin levels in perioperative period were compared between the two groups. RESULTS AND CONCLUSIONS: The operation time in the SurgifloTM group was significantly shorter than that in the gelatin sponge group [(105±26) vs.(118±32) min, P<0.05]. The amount of intraoperative blood loss and total amount of drainage were(156±57) mL and(106±42) mL in the SurgifloTM group which were significantly lower than those in the gelatin sponge group [(204±62) mL,(148±35) mL, P<0.05]. The success rate of hemostasis within 3 minutes in the SurgifloTM group was significantly higher than that in the gelatin sponge group(94% vs. 80%, P<0.05). The change in hemoglobin level during the perioperative period relative to pre-surgery level was significantly higher in the SurgifloTM group was significantly lower than that in the gelatin sponge group [(12.3±3.6) vs.(22.8±4.3) g/L, P<0.05]. No complications such as anaphylaxis, immune rejection, or delayed hematoma occurred in both groups. These results suggest that fluid gelatin SurgifloTM can signi

关 键 词：脊柱手术 止血 流体明胶 明胶海绵 腰椎融合手术 手术时间 不良反应 出血 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学]