中国基层医药
中國基層醫藥
중국기층의약
Chinese Journal of Primary Medicine and Pharmacy
2015年
22期
3417-3418,3419
,共3页
脊柱手术%硬膜损伤%脑脊液漏%术中处理
脊柱手術%硬膜損傷%腦脊液漏%術中處理
척주수술%경막손상%뇌척액루%술중처리
Spinal operation%Dural injury%Cerebrospinal fluid leakage%Intraoperative treatment
目的：观察采用医用胶联合肌瓣治疗脊柱手术中硬膜损伤伴脑脊液漏的临床效果。方法收集脊柱手术中并发硬膜损伤伴脑脊液漏患者36例，其中男性15例，女性21例，年龄26～78岁，平均58岁。术中受损硬膜缝合或修补后，采用康派特医用胶水联合肌瓣或筋膜覆盖粘合处理。术后给予抗生素、及时换药等抗感染处理，并严密观察记录引流液的性质和引流量，每24小时引流量小于50 mL 时拔除引流管，皮肤引流口再次加以缝合。结果研究病例中术后引流液中脑脊液消失时间最短0 d，最长4 d，平均1．5 d；引流管拔除时间最短1 d，最长5 d，平均2 d；所有病例均未发生感染，无其他并发症，伤口均一期愈合。结论硬膜缝合修补后采用康派特医用胶水联合肌瓣或筋膜覆盖粘合是治疗脊柱手术术中硬膜损伤伴脑脊液漏的较佳处理方法。
目的：觀察採用醫用膠聯閤肌瓣治療脊柱手術中硬膜損傷伴腦脊液漏的臨床效果。方法收集脊柱手術中併髮硬膜損傷伴腦脊液漏患者36例，其中男性15例，女性21例，年齡26～78歲，平均58歲。術中受損硬膜縫閤或脩補後，採用康派特醫用膠水聯閤肌瓣或觔膜覆蓋粘閤處理。術後給予抗生素、及時換藥等抗感染處理，併嚴密觀察記錄引流液的性質和引流量，每24小時引流量小于50 mL 時拔除引流管，皮膚引流口再次加以縫閤。結果研究病例中術後引流液中腦脊液消失時間最短0 d，最長4 d，平均1．5 d；引流管拔除時間最短1 d，最長5 d，平均2 d；所有病例均未髮生感染，無其他併髮癥，傷口均一期愈閤。結論硬膜縫閤脩補後採用康派特醫用膠水聯閤肌瓣或觔膜覆蓋粘閤是治療脊柱手術術中硬膜損傷伴腦脊液漏的較佳處理方法。
목적：관찰채용의용효연합기판치료척주수술중경막손상반뇌척액루적림상효과。방법수집척주수술중병발경막손상반뇌척액루환자36례，기중남성15례，녀성21례，년령26～78세，평균58세。술중수손경막봉합혹수보후，채용강파특의용효수연합기판혹근막복개점합처리。술후급여항생소、급시환약등항감염처리，병엄밀관찰기록인류액적성질화인류량，매24소시인류량소우50 mL 시발제인류관，피부인류구재차가이봉합。결과연구병례중술후인류액중뇌척액소실시간최단0 d，최장4 d，평균1．5 d；인류관발제시간최단1 d，최장5 d，평균2 d；소유병례균미발생감염，무기타병발증，상구균일기유합。결론경막봉합수보후채용강파특의용효수연합기판혹근막복개점합시치료척주수술술중경막손상반뇌척액루적교가처리방법。
Objective To report a method of handling dural injury with cerebrospinal fluid leakage during the spinal operation process and analyze its effect,to comparatively analyze with the existing methods and to find a better way processing this problem.Methods A total of 36 patients with dural injury and cerebrospinal fluid leakage during the spinal operation process were collected.Among these clinical cases,there were 15 males,21 females,age ranged from 26 to 78 years old,average 58 years old.During the spinal operation process,the injured dura was sutured or repaired.After that,the dural wound was glued with a piece of muscle or fascia by a kind of medical glue named KangPaiTe.After the operation,broad -spectrum antibiotics and timely fresh dressing changing for the wound were applied.The nature and volume of the drainage fluid was documented and analyzed.When the volume of the drainage fluid was below 50mL per day,the drainage tube was pulled away,and the incision of the drainage tube was sutured again.Results The cerebrospinal fluid leakage lasted from 0 day to 4 days,average 1.5 days;the drainage tube was placed from 1 day to 5 days,average 2 days;no wound infection and other complications occurred among all the clini-cal cases included in this study.Conclusion After the injured dura was sutured or repaired,gluing the dural wound with a slice of muscle or fascia by a kind of medical glue named Kangpaite is a better method of handling dural injury with cerebrospinal fluid leakage.
