两种硬脊膜密封修复方式预防脑脊液漏的比较
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东南大学附属中大医院

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中央高校基本科研业务费专项资金资助项目(编号:2242019K40257)


Comparison of two dural sealing repair methods for prevention of cerebrospinal fluid leakage
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Zhongda Hospital, Southeast University,

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the Fundamental Research Funds for the Central Universities (2242019K40257)

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    摘要:

    [目的] 比较两种硬脊膜密封修复方式预防脑脊液漏的疗效。[方法] 2015年1月-2018年12月手术治疗椎管内硬膜下肿瘤患者72例。32例在肿瘤切除后缝合硬脊膜并覆盖明胶海绵(明胶组),40例在肿瘤切除后缝合硬脊膜并覆盖脂肪联合明胶海绵(复合组)。比较两组围手术期和随访结果。[结果] 两组在手术时间、术中出血量、硬脊膜切开长度和手术部位感染发生率方面差异均无统计学意义(P>0.05)。复合组在术后引流量、引流时间、术后住院时间和脑脊液漏发生率方面均低于明胶组(P<0.05)。患者平均随访时间为(28.24±4.63)个月。随时间推移,两组患者VAS评分均显著减少(P<0.05)(P<0.05)。在相同时间点,两组间VAS评分比较差异无统计学意义(P>0.05)。两组患者改良Macnab疗效评定结果比较差异无统计学意义(P>0.05)。[结论] 对于椎管内硬膜下肿瘤患者,切除肿瘤并缝合硬脊膜后覆盖脂肪联合明胶海绵的临床效果优于覆盖明胶海绵。

    Abstract:

    [Objective] To compare the outcomes of two dural sealing repair methods for prevention of cerebrospinal fluid leakage. [Methods] A retrospective study was conducted on 72 patients with intraspinal subdural tumors from January 2015 to December 2018. Of them, 32 patients underwent gelatin sponge covering after tumor resection and dural suture, and the remaining 40 patients underwent fat and gelatin sponge covering after tumor resection and dural suture. The clinical results were compared between the two groups. [Results] There were no significant differences in operative duration, intraoperative blood loss, length of dural incision and incidence of surgical site infection between the two groups (P>0.05). The postoperative drainage volume, drainage time, postoperative hospital stay and incidence of cerebrospinal fluid leakage in the fat and gelatin sponge group were all lower than those in the gelatin sponge group (P<0.05). The mean follow-up time was (28.24±4.63) months. The VAS scores in both groups decreased significantly over time (P<0.05). At the same time point, there was no statistically significant difference in VAS scores between the two groups (P>0.05). There was no statistical significance in the efficacy of modified Macnab between the two groups (P>0.05). [Conclusion] For patients with intraspinal subdural tumors, covering with fat and gelatin sponge after removing tumor and suturing dura was superior to covering with gelatin sponge.

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  • 收稿日期:2021-07-27
  • 最后修改日期:2022-01-04
  • 录用日期:2022-01-20
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