Liu Meng, Xin Bing, Liu Yong-Tao, Huang Dong, Li Ning
Department of Spine Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China.
Zhongguo Gu Shang. 2020 Jan 25;33(1):53-8. doi: 10.3969/j.issn.1003-0034.2020.01.010.
To explore the hemostatic effect of absorbable hemostatic fluid gelatin in single anterior cervical subtotal corpectomy and decompression fusion (ACCF) .
From August 2014 to February 2018, 44 patients with single anterior cervical corpectomy decompression and fusion were selected and divided into two groups:22 cases in experimental group including 10 males and 12 females with an average age of (55.6±9.7) years old, were treated by hemostasis with absorbable hemostasis fluid gelatin; 22 cases in control group including 11 males and 11 females with an average age of (54.4± 11.1) years old were treated by hemostasis with traditional hemostasis method. The operation time, decompression time, intraoperative hemorrhage, postoperative negative pressure drainage, postoperative neurological improvement rate (JOA%) , postoperative bone fusion time, postoperative titanium mesh subsidence rate, postoperative hematoma and other postoperative complications were compared between the two groups.
The operative time of the experimental group (83.1±19.2) min was significantly shorter than that of the control group (89.5±17.0) min (<0.05) ; the decompression time of the spinal canal in the two groups was (52.4±13.7) , (56.1±14.6) min, with a statistically significant difference (=0.001) ; the amount of bleeding in the two groups was (49.9±12.4) , (90.6±36.7) ml, with a statistically significant difference (<0.05) ; the total amount of drainage in the negative pressure drainage ball after operation in the two groups was (42.5±18.3) , (60.0±22.8) ml, the difference was statistically significant (<0.05) . There was no statistically significant difference in the improvement rate of nerve function between the two groups at 1 week after operation, and the improvement rate of nerve function in the experimental group was better than that in the control group at 3 and 6 months after operation. In the two groups, bone fusion was obtained 6 months after operation, no obvious titanium mesh subsidence was found in 3 months after operation, no acute hematoma, CSF leakage and other postoperative complications were found.
Absorbable hemostatic fluid gelatin has a significant hemostatic effect in ACCF operation, can maintain a good operation field, can reduce the decompression time of spinal canal, reduce the amount of bleeding during operation and the amount of bleeding after operation. It is a more effective and safe hemostatic material than the traditional hemostatic method.
探讨可吸收止血液明胶在单节段颈椎前路椎体次全切除减压融合术(ACCF)中的止血效果。
选取2014年8月至2018年2月行单节段颈椎椎体次全切除减压融合术的患者44例,分为两组:实验组22例,男10例,女12例,平均年龄(55.6±9.7)岁,采用可吸收止血液明胶止血;对照组22例,男11例,女11例,平均年龄(54.4±11.1)岁,采用传统止血方法止血。比较两组手术时间、减压时间、术中出血量、术后负压引流量、术后神经功能改善率(JOA%)、术后骨融合时间、术后钛网下沉率、术后血肿及其他术后并发症。
实验组手术时间(83.1±19.2)min明显短于对照组(89.5±17.0)min(<0.05);两组椎管减压时间分别为(52.4±13.7)、(56.1±14.6)min,差异有统计学意义(=0.001);两组出血量分别为(49.9±12.4)、(90.6±36.7)ml,差异有统计学意义(<0.05);两组术后负压引流球引流量分别为(42.5±18.3)、(60.0±22.8)ml,差异有统计学意义(<0.05)。术后1周两组神经功能改善率差异无统计学意义,术后3、6个月实验组神经功能改善率优于对照组。两组术后6个月均获得骨融合,术后3个月未发现明显钛网下沉,未发现急性血肿、脑脊液漏等术后并发症。
可吸收止血液明胶在ACCF手术中具有显著的止血效果,能保持良好的术野,可缩短椎管减压时间,减少术中出血量及术后引流量。是一种比传统止血方法更有效、安全的止血材料。