皮肤吻合器在神经外科手术中的应用

目的探讨皮肤吻合器在神经外科手术切口缝合中的应用效果。方法我科自2010年9月至2014年1月对120例神经外科手术切口采用不同方法进行皮肤缝合,根据缝合方法分为吻合器组和传统组,各60例;吻合器组采用一次性皮肤吻合器缝合切口,传统组采用传统丝线缝合切口。观察记录两组手术缝合速度、术后脑脊液切口漏发生率、切口感染发生率、切口缘皮肤坏死发生率。结果吻合器组缝合速度为（9.5±0.7）cm/min,术后脑脊液切口漏发生率为1.7%（/60）,无切口感染及切口缘皮肤坏死病例;传统组缝合速度为（3.4±0.3）cm/min,术后脑脊液切口漏发生率为10%（6/60）,切口感染发生率为3.3%（2/60）,切口缘皮肤坏死发生率为13.3%（8/60）;两组切口吻合速度及术后切口缘皮肤坏死发生率均差异显著（P〈0.05）。结论对于神经外科手术切口,皮肤吻合器缝合皮肤切口较传统丝线缝合有明显的优势。

Application of skin staplers to neurosurgery

ObjectiveTo explore the applied value of skin staplers to neurosurgical operation.MethodsOne hundred and twentypatients who need the neurosurgical operation were randomly divided into group A（n=60）, in which the skin stapler was intraoperativelyused for sewing the skin and group B（n=60）, in which the operative silk was used for sewing the skin. The speed of surgical sutures, theoccurrent rate of postoperative cerebrospinal fluid leak, the occurrent rate of wound infection, and the rate of skin necrosis in the woundedge were observed in all the patients.ResultsThe speed of surgical sutures [（9.5±0.7）cm/min] was significantly faster in group A thanthat [（3.4±0.3）cm/min] in group B. The postoperative complication in group B included the cerebrospinal fluid leak in 6 patients（10.0%,6/60）, would infection in 2（3.3%, 2/60） and wound edge skin necrosis in 8（13.3%, 8/60）. There was the cerebrospinal fluid leak only in1 patient（1.7%, 1/60） in group A after the operation. The occurrent rate of the postoperative complication（26.7, 16/60） was significantlyhigher in group B than that in group A（P〈0.01）.The occurrent rate of skin necrosis in wound edge（13.3%, 8/60） was significantly highergroup B than that in group A（P〈0.05）.ConclusionsThe duration of the operation and the postoperative complication may be reduced byintraoperative use of the skin staplers. The skin staplers are worthy to be widely used in the neurosurgical operation.