含有血的局部血静剂对双门内镜脊柱外科手术中术后脊柱外皮血瘤的影响
Young Rok Ko1, Dong Ki Ahn1, Jung Soo Lee1
1Department of Orthopaedic Surgery, Seoul Sacred Heart General Hospital, Seoul, Korea.
Asian spine journal
|February 21, 2024
概括
含有血栓素的局部止血药 (TCLH) 在双门内镜脊柱手术 (BESS) 中显著降低形态测量术后脊柱外周血瘤 (POSEH). 不使用TCLH是POSEH发展的关键风险因素.
科学领域:
- 神经外科 神经外科
- 脊柱外科手术 脊柱外科手术
- 最少侵入性的手术
背景情况:
- 手术后脊柱外周血瘤 (POSEH) 是双门内镜脊柱手术 (BESS) 的已知并发症.
- 含有血栓素的局部静止剂 (TCLH) 在常规脊柱手术 (CSS) 中对静止有效,但在BESS中未得到充分研究.
- 这项研究解决了关于BESS中TCLH疗效的知识差距.
研究的目的:
- 调查TCLH对BESS中POSEH的预防作用.
- 为了比较在BESS期间具有和没有TCLH的形态和症状POSEH的发病率.
- 在BESS中识别POSEH的风险因素.
主要方法:
- 追溯病例控制研究设计.
- 接受BESS的患者被分为两组:接受TCLH (A组) 和未接受TCLH (B组) 的患者.
- 评估了POSEH的形状和症状,并使用多变量逻辑回归分析了风险因素.
主要成果:
- 在没有TCLH的组 (B组) (p=0.019) 中,形态测量POSEH显著增加 (p=0.019).
- 虽然症状性POSEH在TCLH组 (A组,4.6%) 与B组 (9.5%) 相比较较低,但这种差异在统计学上并不显著 (p=0.136).
- 不使用TCLH和手术前诊断脊柱狭窄是形态测量POSEH的重要风险因素.
结论:
- 使用TCLH与BESS的形态测量POSEH的发病率降低有关.
- 需要双边减压或骨暴露增加的患者面临更高的血瘤形成风险.
- 在BESS中,TCLH可能有助于防止POSEH导致的严重的囊压缩.
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