可吸收止血流体明胶和可吸收明胶海绵在ACDF术中的止血作用对比

摘要

Objective To compare the hemostatic effect between absorbable hemostatic fluid gelatin (HFG) and absorbable gelatin sponge (GS) during anterior cervical discectomy and fusion procedure (ACDF) in treating two-level cervical spondylosis.Methods From Feb 2014 to Aug 2015,a total of 62 patients with cervical spondylosis who were going to undergo two-level ACDF fixation using zero-profile implant,were enrolled in this study.Sixty-two patients were randomly divided into HFG group (31 cases,only using HFG) and GS group (31cases,only using GS).The operative duration,time for spinal canal decompression,the volume of blood loss,and the volume of drainage between two groups were compared.The postoperative complications were recorded,and especially the postoperative hematoma was focused on.Results There was no significant difference in average operative duration between two groups (P＞0.05).The time for spinal canal decompression,the operative blood loss,and post-operative drainage of HFG group were significantly less than those of GS group.No acute neck hematoma related complication in both groups was found postoperatively.Conclusion Compared with GS,HFG can significantly decrease spinal canal decompression time,operative blood loss,and post-operative drainage in ACDF procedure.HFG is a safe and effective method hemostasis for ACDF in treating two-level cervical spondylosis.%目的 比较可吸收止血流体明胶和可吸收明胶海绵在两个节段颈椎前路间盘切除融合(ACDF)术中的止血效果.方法 筛选2014年2月～2015年10月在我科行两个节段ACDF (Zero-P)手术的颈椎病患者62例,随机分为2组:流体明胶组31例,使用可吸收止血流体明胶止血;明胶海绵组31例,使用可吸收明胶海绵止血.比较两组手术时间、椎管减压时间、术中出血量、术后引流量,术后不良事件及术后并发症.结果 两组患者手术时间分别为(156.1±20.6) min、(164.5±30.8) min,二者无显著统计学差异;两组椎管减压所用时间分别为(91.2±17.2) min、(108.4±27.5) min,P=0.005,HFG组椎管减压时间少于GS组,差异具有统计学意义.流体明胶组患者术中出血量及术后引流量均少于明胶海绵组,术中出血量分别为(45.2±16.3) mL VS(106.1±107.8)mL,P＜0.05;术后引流量分别为(38.1±34.5) mL VS (76.3±56.2) mL,P＜0.05,差异具有统计学意义.两组患者均未出现术后颈部急性血肿及其他严重术后并发症.结论 在ACDF术中,可吸收流体明胶操作简单,可以减少椎管减压时间、术中出血量和术后引流量,是一种安全、有效并且效果优于传统止血方式的止血材料.