Li Quan You, Lee Osung, Han Ho Sung, Kim Gang-Un, Lee Chee Kean, Kang Sung Shik, Lee Myung Ho, Cho Hyeon Guk, Kim Ho-Joong, Yeom Jin S
Spine Center and Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Asian Spine J. 2015 Dec;9(6):909-15. doi: 10.4184/asj.2015.9.6.909. Epub 2015 Dec 8.
Retrospective fusion level(s)-, age-, and gender-matched analysis.
To determine whether the application of a topical gelatin-thrombin matrix sealant (Floseal) at the end of anterior cervical discectomy and fusion (ACDF) can reduce the amount of postoperative hemorrhage.
The effect of the matrix sealant in decreasing postoperative hemorrhage following ACDF has not been reported.
Matrix sealant was (n=116, study group) or was not applied (n=58, control group) at the end of ACDF. Patients were selected by 1:2 matching criteria of fusion level(s), age, and gender. Seven parameters described below were compared between the two groups.
The total drain amount for the first 24 hours (8±9 versus 27±22 mL), total drain amount until the 8-hour drainage decreased to ≤10 mL (8±10 versus 33±26 mL), and the total drain amount until 6 AM on the first postoperative day (7±8 versus 24±20 mL) were significantly lower in the study group than the control group (all p<0.001). The time for the 8-hour drainage to decrease to ≤10 mL was significantly lower in the study group (10±5 versus 26±14 hours, p<0.001). The 8-hour drainage decreased to ≤10 mL on the operation day in most patients (88%) in the study group versus mostly on the first (48%) or second (33%) postoperative day in the control group (p<0.001). The total drain amount until 6 AM on the first postoperative day was 0 mL in 43% of patients in the study group and in 7% in the control group (p<0.001). No patient in either group required hematoma evacuation.
Application of the topical matrix sealant at the end of ACDF can significantly reduce the amount of postoperative hemorrhage.
回顾性融合节段、年龄和性别匹配分析。
确定在颈椎前路椎间盘切除融合术（ACDF）结束时应用局部明胶 - 凝血酶基质密封剂（Floseal）是否能减少术后出血量。
尚未有关于基质密封剂减少ACDF术后出血效果的报道。
在ACDF结束时应用基质密封剂的患者为116例（研究组），未应用的患者为58例（对照组）。患者按照融合节段、年龄和性别的1:2匹配标准选取。比较两组以下七个参数。
研究组在前24小时的总引流量（8±9对27±22毫升）、直至8小时引流量降至≤10毫升时的总引流量（8±10对33±26毫升）以及术后第一天上午6点时的总引流量（7±8对24±20毫升）均显著低于对照组（均p<0.001）。研究组8小时引流量降至≤10毫升的时间显著更短（10±5对26±14小时，p<0.001）。研究组大多数患者（88%）在手术当天8小时引流量降至≤10毫升，而对照组大多在术后第一天（48%）或第二天（33%）（p<0.001）。研究组43%的患者术后第一天上午6点时总引流量为0毫升，对照组为7%（p<0.001）。两组均无患者需要进行血肿清除。
在ACDF结束时应用局部基质密封剂可显著减少术后出血量。
