负压封闭引流技术在原发性骶骨肿瘤后路切口中的应用

目的 探讨负压封闭引流（VSD）技术在原发性骶骨肿瘤后路切口中的应用价值.方法 对2011年1月至2012年12月期间接受后入路手术治疗的36例原发性骶骨肿瘤患者应用VSD技术,同时在创腔内常规置人多孔硅胶引流管外接负压引流球.6～7 d后拆除VSD装置,硅胶引流管在引流液＜30 ml/24h后拔除.观察切口并发症发生情况.结果 36例患者中31例（86.11％）切口甲级愈合,2例（5.56％）发生切口延迟愈合,3例（8.33％）发生切口感染.术后随访3个月至2年,29例获随访.26例患者生存良好,1例骨肉瘤患者术后11个月因远处转移致多器官功能衰竭死亡,2例骶骨脊索瘤患者因局部复发再次行肿瘤切除术.结论 VSD技术可有效预防原发性骶骨肿瘤患者术后切口感染、不愈合,疗效明显.

Application of vacuum sealing drainage in posterior incision of primary sacral tumors

Objective To explore the application value of vacuum sealing drainage（VSD） in posterior incision of primary sacral tumor.Methods From January 2011 to December 2012,the VSD was applied in the posterior incisions of 36 patients with primary sacral tumor who underwent surgery,and porous silica gel drainage tube was conventionally placed inside the wound cavity to realize the external connection with negative pressure drainage ball.VSD was removed after 6-7 days,silica gel drainage tube was removed when the drainage fluid was less than 30 ml/24 h.The indsion complications were observed.Results In 36patients,the incision healed perfectly in 31 cases（86.11％）,delay in 2 cases（5.56％）,the incision infection in 3 cases（8.33％）.29 cases were followed up with 3 months to 2 years,26 cases survived well,one case with osteosarcoma died of multiple organ failure resulted from distant metastasis 11 months after operation,2 cases with sacral chordoma were local recurrences,and tumor resection was performed once again.Conclusion The application of VSD could effectively prevent the incision infection and nonunion for patients with primary sacral tumor after operation,which realized good curative effects.