人工硬膜治疗脊柱后路手术中脑脊液漏  

Artificial dura in treatment of cerebrospinal fluid leakage during posterior spinal surgery

作　　者：唐勇 史洪洋 赵天翌 侯洋 史建刚 贾连顺 史国栋 Tang Yong;Shi Hongyang;Zhao Tianyi;Hou Yang;Shi Jiangang;Jia Lianshun;Shi Guodong(Department of No.l Special Field Service,Navy Characteristic Medical Center9 Navy Medical University,Shanghai 200050,China;Department of Orthopaedics,Changzheng Hospital,Navy Medical University,Shanghai 200003,China)

机构地区：[1]海军军医大学海军特色医学中心特勤外一科,上海200050 [2]海军军医大学长征医院骨科,上海200003

出　　处：《脊柱外科杂志》2021年第4期217-220,共4页Journal of Spinal Surgery

基　　金：国家自然科学基金面上项目(81371252);上海市卫生和计划生育委员会科研课题(201840264)。

摘　　要：目的探讨人工硬膜覆盖硬膜囊漏口治疗脊柱后路手术中脑脊液漏的临床疗效。方法回顾性分析海军军医大学长征医院2016年1月—2018年12月脊柱后路手术中发生脑脊液漏的101例患者临床资料,根据治疗方案分为对照组(n=56,术中采用明胶海绵覆盖硬膜囊漏口)和试验组(n=45,术中采用可吸收人工硬膜覆盖硬膜囊漏口)。观察2组患者术后脑脊液漏发生率、术后并发症发生率、术后48 h引流量、引流管留置时间、切口愈合时间等的差异。结果对照组术后脑脊液漏发生率为76.79%,术后并发症发生率为32.14%,术后48 h引流量为(352.55±75.11)mL,引流管留置时间为(7.55±2.38)d,切口愈合时间为(15.78±2.36)d。试验组脑脊液漏发生率为15.56%,术后并发症发生率为6.67%,术后48 h引流量为(160.02±50.05)mL,引流管留置时间为(1.87±0.69)d,切口愈合时间为(14.16±1.89)d。试验组术后脑脊液漏发生率、术后并发症发生率、术后48 h引流量、引流管留置时间、切口愈合时间均显著优于对照组,差异有统计学意义(P < 0.05)。结论人工硬膜可显著降低术后脑脊液漏及相关并发症发生率,显著缩短引流管留置时间及切口愈合时间,是治疗脊柱后路手术中脑脊液漏的有效手段。Objective To investigate the clinical efficacy of artificial dura in the treatment of cerebrospinal fluid leakage during posterior spinal surgery.Methods From January 2016 to December 2018,101 patients with cerebrospinal fluid leakage during posterior spinal surgery in Changzheng Hospital of Navy Medical University were retrospectively analyzed.According to the treatment plan,they were divided into control group(n=56,gelatin sponge was used to cover the dural sac leakage)and experiment group(n=45,absorbable artificial dural was used to cover the dural sac leakage).The incidence of postoperative cerebrospinal fluid leakage,incidence of postoperative complications,drainage volume within 48 h after operation,retention time of drainage tube and incision healing time were observed and compared between the 2 groups.Results In the control group,the incidence of postoperative cerebrospinal fluid leakage was 76.79%,the incidence of postoperative complications was 32.14%,the drainage volume within 48 h after operation was(352.55±75.11)mL,the retention time of drainage tube was(7.55±2.38)d,and the incision healing time was(15.78±2.36)d.In the experiment group,the incidence of postoperative cerebrospinal fluid leakage was 15.56%,the incidence of postoperative complications was 6.67%,the drainage volume within 48 h after operation was(160.02±50.05)mL,the retention time of drainage tube was(1.87±0.69)d,and the incision healing time was(14.16±1.89)d.The incidence of postoperative cerebrospinal fluid leakage,incidence of postoperative complications,drainage within 48 h after operation,retention time of drainage tube and incision healing time in the experiment group were significantly better than those in the control group,and all with a statistical significance(P<0.05).Conclusion Artificial dura can significantly reduce the incidence of postoperative cerebrospinal fluid leakage and related complications,significantly shorten the retention time of drainage tube and incision healing time,thus being an effective method for th

关 键 词：脊柱 外科手术 硬膜下积液 假体和植入物 

分 类 号：R681.5[医药卫生—骨科学]