川北医学院学报
川北醫學院學報
천북의학원학보
JOURNAL OF NORTH SICHUAN MEDICAL COLLEGE
2015年
3期
349-352
,共4页
付能高%何江涛%张志明%张映波%蒋成
付能高%何江濤%張誌明%張映波%蔣成
부능고%하강도%장지명%장영파%장성
负压封闭引流%胸腰椎病变%脑脊液漏%临床疗效
負壓封閉引流%胸腰椎病變%腦脊液漏%臨床療效
부압봉폐인류%흉요추병변%뇌척액루%림상료효
Vacuum sealing drainage VSD%Thoracolumbar disease%Cerebrospinal fluid leakage ( CSFL)%Clinical efficacy
目的::观察负压封闭引流( vacuum sealing drainage,VSD)治疗胸腰椎病变术后脑脊液漏的临床疗效。方法:我科2010年2月至2014年2月23例采用VSD治疗胸腰椎病变术后脑脊液漏患者,均常规治疗,彻底清除切口内炎性水肿和坏死组织,生理盐水和稀释碘伏纱布条反复清洗切口,干纱布条将切口擦拭干净,于切口表面或切口内置VSD,术后俯卧位48~72 h。结果:所有病例切口完全愈合,未出现再次手术修补病例。其中17例置VSD 5~7 d后,换药7~10 d拆线出院;6例第一次VSD术后5~7 d,切口仍有少量渗液,再次置VSD 5~7 d后,换药4~5 d拆线出院。随访6个月~2年,所有病例无头晕、头痛、恶心及胸腰背部疼痛等症状,有2例发现较小的脑脊液囊肿,因无腰痛及神经症状而未处理。结论: VSD是治疗胸腰椎病变术后脑脊液漏有效而无创的方法。
目的::觀察負壓封閉引流( vacuum sealing drainage,VSD)治療胸腰椎病變術後腦脊液漏的臨床療效。方法:我科2010年2月至2014年2月23例採用VSD治療胸腰椎病變術後腦脊液漏患者,均常規治療,徹底清除切口內炎性水腫和壞死組織,生理鹽水和稀釋碘伏紗佈條反複清洗切口,榦紗佈條將切口抆拭榦淨,于切口錶麵或切口內置VSD,術後俯臥位48~72 h。結果:所有病例切口完全愈閤,未齣現再次手術脩補病例。其中17例置VSD 5~7 d後,換藥7~10 d拆線齣院;6例第一次VSD術後5~7 d,切口仍有少量滲液,再次置VSD 5~7 d後,換藥4~5 d拆線齣院。隨訪6箇月~2年,所有病例無頭暈、頭痛、噁心及胸腰揹部疼痛等癥狀,有2例髮現較小的腦脊液囊腫,因無腰痛及神經癥狀而未處理。結論: VSD是治療胸腰椎病變術後腦脊液漏有效而無創的方法。
목적::관찰부압봉폐인류( vacuum sealing drainage,VSD)치료흉요추병변술후뇌척액루적림상료효。방법:아과2010년2월지2014년2월23례채용VSD치료흉요추병변술후뇌척액루환자,균상규치료,철저청제절구내염성수종화배사조직,생리염수화희석전복사포조반복청세절구,간사포조장절구찰식간정,우절구표면혹절구내치VSD,술후부와위48~72 h。결과:소유병례절구완전유합,미출현재차수술수보병례。기중17례치VSD 5~7 d후,환약7~10 d탁선출원;6례제일차VSD술후5~7 d,절구잉유소량삼액,재차치VSD 5~7 d후,환약4~5 d탁선출원。수방6개월~2년,소유병례무두훈、두통、악심급흉요배부동통등증상,유2례발현교소적뇌척액낭종,인무요통급신경증상이미처리。결론: VSD시치료흉요추병변술후뇌척액루유효이무창적방법。
Objective:To observe the clinical efficacy of vacuum sealing drainage( VSD) in the treatment of postoperative cere-brospinal fluid leakage(CSFL) of thoracolumbar vertebral body disease. Methods: From February 2010 to February 2014,23 cases with postoperative CSFL of thoracolumbar vertebral body disease were treatted by VSD in our department. All cases received convention-al treatment,thorough cleaning out wound inflammatory edema and necrotic tissue,repeated washing incision by physiological saline and diluted iodophor gauze strip,wiping clean wound with dry gauze strip,placing VSD on cut surface or partly in incision and prone posi-tion 48-72 hours after operation. Results:All patients acquired wound healing completely,and there were no cases of surgical repair again. After 5-7 days of placing VSD,17 patients were discharged through changing dressings for 7-10 days again. After 5-7 days of placing VSD for the first time,6 patients had still a little incision oozing,after 5-7 days of putting VSD again,and the 6 cases were dis-charged by additional changing dressings for 4-5 days. Following up from 6 months to 2 years,in all cases there were no dizziness, headache,nausea,thoracic and lumbar back pain and other symptoms. 2 cases after lumbar spine surgery had small cerebrospinal fluid cysts,because there were no pain and neurological symptoms without treatment. Conclusion:VSD is an effective and atraumatic meth-od to remedy CSFL of the thoracic and lumbar lesions after operation.