纤维蛋白黏合剂在硬膜内脊髓肿瘤术中的应用

摘要

Objective:To apply fibrin sealant after closurc of an incidcntal or intended durotomy to reduce the complications.Fibrin sealant can not be used after closure of an intended durotomy.We investigated the efficacy of fibrin sealant for primary intradural spinal cord tumor surgery.Methods:Selecting the data of 500 patients with primary intradural spinal cord tumors without extradural extension from January 2012 to January 2015.They were divided into control group and experimental group,according to the use of fibrin sealant.The primary outcome was the occurrence of complications.The covariates were hospitalization time,maximum temerature of the first and second day after operation,drainage volume.Results:Complications occurred in 28 patients (7 patients in control group and 21 patients in experimental group,P =0.50).The postoperative ambulation status and operation time were significant factors,whereas the use of a fibrin sealant was not.Conclusion:The occurrence of postoperative complications was not associated with the use of fibrin sealant after surgery for a primary intradural spinal cord tumor.%目的:在偶发的和计划的硬膜内脊髓肿瘤手术中使用纤维蛋白黏合剂可减少并发症的发生,但计划性开颅手术未要求使用纤维蛋白黏合剂.评估纤维蛋白黏合剂对原发性硬膜内脊髓肿瘤手术临床疗效的影响.方法:选取自2012年1月至2015年1月就诊于我院的500名原发性硬膜内脊髓肿瘤且无硬膜外伴发症患者为研究对象,按手术中纤维蛋白黏合剂的使用情况,分为对照组(未使用纤维蛋白黏合剂,100人)和实验组(使用纤维蛋白黏合剂,400人).评估主要指标是并发症,次要指标是住院时间、手术后1天以及2天身体最高体温和引流液量.结果:28人发生并发症(对照组7人,实验组21人,P=0.50).手术后行走状态和手术时间是并发症发生的主要影响因素,纤维蛋白黏合剂的使用不是手术结果的影响因素.结论:原发性硬膜内脊髓肿瘤手术后并发症的发生与纤维蛋白黏合剂的使用无相关性.手术中使用纤维蛋白黏合剂可根据手术情况确定.