两种止血材料在颈椎单开门椎管扩大成形术中的止血效果观察

目的:比较可吸收止血流体明胶(HFG)和可吸收明胶海绵(GS)在颈椎后路单开门椎管扩大成形术中的止血效果。方法:回顾性分析2014年2月至2016年5月接受颈椎后路单开门椎管扩大成形术治疗的患者83例,根据患者术中使用不同止血材料分两组:HFG组41例,男30例,女11例;年龄29~81岁,平均(55.6±11.6)岁;其中14例为单纯颈椎管狭窄症,9例合并后纵韧带骨化,18例合并多节段颈椎间盘突出。GS组42例,男32例,女10例;年龄36~78岁,平均(55.4±11.1)岁;其中12例为单纯颈椎管狭窄症,10例合并后纵韧带骨化,20例合并多节段颈椎间盘突出。两组患者性别、年龄及病变类型等一般资料比较,差异均无统计学意义(P0.05)。比较两组手术时间、术中出血量、术后引流量、术后不良事件及术后并发症。结果:HFG组和GS组患者手术时间分别为(137.2±30.0)、(154.8±33.5)min(P0.05);术中出血量分别为(156.1±74.6)、(242.9±120.7)ml(P0.001);术后引流量分别为(212.1±67.6)、(303.3±115.5)ml(P0.001)。HFG组手术时间、术中出血量及术后引流量均少于GS组。两组患者均未发生术后切口急性血肿及其他止血相关并发症。结论:颈椎后路单开门椎管扩大成形术中,HFG操作简单,可以减少手术时间、术中出血量和术后引流量,是一种安全并且效果优于传统止血方式的止血材料。

Analysis of clinical effects of absorbable hemostatic fluid gelatin and absorbable gelatin sponge on the hemostasis during operation of unilateral open-door cervical expansive laminoplasty

Objective: To compare the hemostatic effect between absorbable hemostatic fluid gelatin (HFG) and absorbable gelatin sponge(GS) during operation of unilateral open-door cervical expansive laminoplasty. Methods: The clinical data of 83 patients underwent unilateral open-door cervical expansive laminoplasty from February 2014 to May 2016 were retrospectively analyzed. According to the used hemostatic materials,patients were divided into two groups. In HFG group,there were 30 males and 11 females,ranging in age from 29 to 81 years,with an average of(55.6±11.6)years;14 cases were simple cervical spinal stenosis,9 were cervical spinal stenosis and ossification of posterior longitudinal ligament,and 18 were cervical spinal stenosis complicated with multiple cervical disc herniation. And in GS group,there were 32 males and 10 females,ranging in age from 36 to 78 years,with an average of (55.4±11.1) years;12 cases were simple cervical spinal stenosis,10 were cervical spinal stenosis complicated with ossification of posterior longitudinal ligament,and 20 were cervical spinal stenosis complicated with multiple cervical disc herniation. There was no significant difference in the age,gender,and disease categories of patients between two groups (P>0.05). The operative time,intraoperative bleeding,postoperative drainage,and postoperative complications were compared between two groups. Results: The average operative time,intraoperative bleeding,and postoperative drainage in HFG group were(137.2±30.0) min,(156.1±74.6) ml,and (212.1±67.6) ml,respectively;and in GS group were (154.8±33.5) min,(242.9±120.7) ml,and(303.3±115.5) ml,respectively. There were significantly differences in above items between two groups(P<0.05). No acute heamatoma or related complications was found postoperatively. Conclusion: Compared with GS,HFG can obviously decrease operative time,intraoperative bleeding,and postoperative drainage. It is a safe and effective hemostatic material for the operation of unilateral open-door cervical expansive laminoplasty.