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用一种新的凝血缝合技术实现脊髓硬脑膜的水密性闭合(作者译)

[Water-tight closure of spinal dura with a new clot suture technique (author's transl)].

作者信息

Matras H, Jesch W, Kletter G, Dinges H P

出版信息

Wien Klin Wochenschr. 1978 Jun 9;90(12):419-25.

PMID:307310
Abstract

A new clot-suturing Technique (using high-concentration fibrinogen solutions) for water-tight closure of the dura is reported. Six dogs underwent laminectomy of the thoracic spine with medial longitudinal incision in the chordal dura. After the dural split had been sealed with natural tissue adhesive and closure of the wound in layers, the animals were sacrificed at intervals of 1 to 21 days postoperatively and the chordal segments involved were removed and histologically examined. Early fibrinolysis of the clot was prevented by adding a natural proteinase inhibitor and factor XIII concentrate to the clotting substances. Histological analysis showed that healing was almost complete after 2 weeks, with delicate connective tissue overgrowing the dural split. After complete reabsorption of fibrin, the originally abundant absorbent granulation tissue had largely disappeared. Among the satisfactory results of fibrin suturing are optimum healing tendency in the fibrin-sutured region, absence of tissue irritation and neurotoxicity, which are known attributes of the synthetic alkl-cyano-acrylate tissue adhesives.

摘要

据报道,一种用于硬脑膜水密闭合的新型凝血缝合技术(使用高浓度纤维蛋白原溶液)。六只狗接受了胸椎椎板切除术,在脊髓硬脑膜上做内侧纵向切口。用天然组织粘合剂封闭硬脑膜切口并分层缝合伤口后,在术后1至21天的间隔时间处死动物,取出受累的脊髓节段并进行组织学检查。通过向凝血物质中添加天然蛋白酶抑制剂和因子XIII浓缩物来防止血凝块的早期纤维蛋白溶解。组织学分析表明,2周后愈合几乎完成,纤细的结缔组织长入硬脑膜切口。纤维蛋白完全吸收后,原本丰富的吸收性肉芽组织已基本消失。纤维蛋白缝合的满意结果包括纤维蛋白缝合区域的最佳愈合趋势、无组织刺激和神经毒性,这些都是合成烷基氰基丙烯酸酯组织粘合剂的已知特性。

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