脊柱手术切口延迟愈合 |
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Received:August 13, 2003
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期刊信息:《中国骨伤》2004年17卷,第8期,第461-463页 |
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:分析脊柱手术切口延迟愈合的原因,探讨促进愈合的方法。
方法:依据我院1988年6月至2002年12月42例脊柱手术切口不愈合的临床资料,对延迟愈合的原因、表现及处理方法进行了分类及讨论。
结果:9例结核患者再次手术后6例愈合,1例窦道形成,2例死亡;切口裂开2例中1例经切口再缝合愈合良好,另1例经10个月长期换药切口愈合;7例切口感染者均在1个月内控制感染;9例脑脊液漏,其中8例经保守治疗愈合,1例行脑脊膜再次修补术;1例硬膜外血肿清除后愈合良好;霉菌感染2例,其中1例经病灶清除后切口愈合,另1例演变成复发性窦道炎;4例压疮去除压迫后溃疡愈合;另外8例切口延迟愈合者中止血水引起者4例,脂肪液化2例,皮肤过敏2例,均经红外线照射后切口愈合。
结论:脊柱手术切口延迟愈合的主要因素为医源性,大部分切口延迟愈合可以通过保守治疗治愈,存在3个月以上的窦道或溃疡需手术处理去除影响愈合的因素。 |
[关键词]:脊柱 外科手术 愈合 |
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Delayed healing of postoperative spinal incision |
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Abstract:
Objective:To analyze causes of delayed healing of spinal incision,and to investigate the way to promote the healing.
Methods:Materials of our hospital from June 1988 to December 2002 were obtained.Causes,clinical manifestation and management of this complication with forty-two patients were classified and dissussed.
Results:Out of the nine tuberculose patients,six healed after second operation,one sinus formation,two died.Out of the two disruption of wound,one was re-sutured and healed,the other healed after a long term (ten months) of dressing changing.Seven infectious incision were controlled within one month.Out of the nine cerebrospinal fluid fistulae,eight were cured conservatively,only one spinal meninges was repaired.One epidural hematoma was cleared and made a good healing.Out of the two mold infection,one was cured after focal clearing,the other developed to chronic recurrent sinusitis.Four patients with sore healed after decompression.The other eight patients (four by hemostasis narcotic,two by liquefied fat,two by dermal allergic papular eczema) had good healing after intra-red therapy.
Conclusion:Main cause of delayed healing of spinal incision is iatrogenic,the majority of them can be treated conservatively,sore or sinus lasting over three months,should be treated properly to remove factors influencing healing process. |
KEYWORDS:Spine Surgical procedure,operative Healing |
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引用本文,请按以下格式著录参考文献: |
中文格式: | 孙国绍.脊柱手术切口延迟愈合[J].中国骨伤,2004,17(8):461~463 |
英文格式: | SUN Guo-shao.Delayed healing of postoperative spinal incision[J].zhongguo gu shang / China J Orthop Trauma ,2004,17(8):461~463 |
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