| 可吸收止血流体明胶在颈前路椎体次全切除减压融合术中的应用 |
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投稿时间：2019-05-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 刘猛 |
LIU Meng |
徐州医科大学研究生学院, 江苏 徐州 221000 |
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| 辛兵 |
XIN Bing |
徐州医科大学附属医院脊柱外科, 江苏 徐州 221000 |
Department of Spine Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
18052268323@189.cn |
| 刘永涛 |
LIU Yong-tao |
徐州医科大学附属医院脊柱外科, 江苏 徐州 221000 |
Department of Spine Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
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| 黄栋 |
HUANG Dong |
徐州医科大学附属医院脊柱外科, 江苏 徐州 221000 |
Department of Spine Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
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| 李宁 |
LI Ning |
徐州医科大学研究生学院, 江苏 徐州 221000 |
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| 期刊信息：《中国骨伤》2020年，第33卷，第1期，第53-58页 |
| DOI：10.3969/j.issn.1003-0034.2020.01.010 |
| 基金项目: |
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中文摘要:
目的：探究可吸收止血流体明胶在单节段颈前路椎体次全切除减压融合术（anterior discectomy fusion，ACCF）中的止血效果。
方法：自2014年8月至2018年2月选取行单节段颈前路椎体次全切除减压融合术患者44例，分为两组：试验组22例，男10例，女12例，年龄（55.6±9.7）岁，术中用可吸收止血流体明胶止血；对照组22例，男11例，女11例，年龄（54.4±11.1）岁，术中采用传统止血方法止血。比较两组手术时间、椎管减压所需时间、术中出血量、术后负压引流量、术后神经功能改善率、术后骨融合时间、术后钛网沉降率、术后血肿发生以及其他术后不良事件并发症。
结果：试验组手术时间（83.1±19.2） min，明显少于对照组的（89.5±17.0） min（P<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（P=0.001）；两组术中出血量分别为（49.9±12.4）、（90.6±36.7） ml，差异有统计学意义（P<0.05）；两组术后负压引流球内引流总量分别为（42.5±18.3）、（60.0±22.8） ml，差异有统计学意义（P<0.05）；两组术后1周神经功能改善率差异无统计学意义，术后3、6个月试验组比对照组有更好神经功能改善率。两组术后6个月均获得骨性融合，术后3个月均未发现明显钛网沉降，均无出现急性血肿、脑脊液漏及其他术后并发症。
结论：可吸收止血流体明胶在ACCF手术中止血效果显著，可保持良好的手术术野，可减少椎管减压时间，减少术中出血量术后引流量，是一种较传统止血方法更有效且安全的止血材料。 |
| 【关键词】明胶海绵,吸收性 止血 减压 脊柱融合术 颈椎病 |
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| Application of absorbable hemostatic fluid gelatin in anterior cervical subtotal vertebral resection and fusion |
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ABSTRACT
Objective: To explore the hemostatic effect of absorbable hemostatic fluid gelatin in single anterior cervical subtotal corpectomy and decompression fusion(ACCF).
Methods: 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.
Results: 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 (P<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 (P=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(P<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(P<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.
Conclusion: 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. |
| KEY WORDS Gelatin sponge,absorbable Hemostasis Decompression Spinal fusion Cervical spondylosis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 刘猛,辛兵,刘永涛,黄栋,李宁.可吸收止血流体明胶在颈前路椎体次全切除减压融合术中的应用[J].中国骨伤,2020,33(1):53~58 |
| 英文格式: | LIU Meng,XIN Bing,LIU Yong-tao,HUANG Dong,LI Ning.Application of absorbable hemostatic fluid gelatin in anterior cervical subtotal vertebral resection and fusion[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(1):53~58 |
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