明胶海绵浸渍血凝酶溶液对腰椎骨折后路固定椎管减压患者出血量的影响

背景：很多临床资料及实验已验证单一的止血材料并不利于伤口愈合或存在一定的不良反应，而两三种不同材料的复合提高了止血材料之间的优势和组织相容性。目的：探讨明胶海绵浸渍血凝酶溶液对腰椎骨折后路固定椎板减压患者出血量的影响。方法：纳入腰椎骨折需进行切开复位椎弓根螺钉内固定联合去椎板减压手术患者50例，其中25例在关闭手术切口前将浸有血凝酶液的可吸收明胶海绵应用于去椎板减压后显露伤口中，为试验组；另25例在关闭手术切口前将单纯明胶海绵应用于去椎板减压后显露伤口中，为对照组。比较两组总体引流量、术后引流终止时间、住院时间、再入院人数及术后并发症等。结果与结论：试验组总体引流量、术后引流终止时间、住院时间明显少于对照组（P 〈0.0001）。两组病例随访期间无感染、硬膜外血肿或再入院患者，未出现与血凝酶浸渍可吸收明胶海绵相关的不良反应。表明在腰椎后路固定椎板减压手术操作中采用明胶海绵浸渍血凝酶溶液止血可显著减少患者的术后伤口引流量，缩短患者住院时间。

Gelatin sponge impregnated with hemocoagulase reduces postoperative blood loss of patients with lumbar fractures undergoing posterior spinal decompression

BACKGROUND：A single hemostatic material has been proved not to facilitate wound healing or to produce certain adverse reactions; while composites composed of two or three different materials can improve the advantage and histocompatibility of hemostatic materials. OBJECTIVE：To investigate the effect of gelatin sponge impregnated with hemocoagulase solution on amount of bleeding in patients with lumbar fractures undergoing posterior spinal decompression. METHODS： Fifty patients with lumbar fractures who were scheduled for open reduction, pedicle screw fixation and laminectomy were enroled, including 25 cases treated with gelatin sponge impregnated with hemocoagulase before surgical incision closure as test group and 25 cases treated with single gelatin sponge before surgical incision closure as control group. Postoperative drainage volume, drainage time, length of stay, number of re-admissions and postoperative complications were compared between the two groups. RESULTS AND CONCLUSION：The postoperative drainage volume, drainage time and length of stay in the test group were significantly less than those in the control group （P 〈 0.000 1）. No infection, epidural hematoma, or re-admission of patients was found, and there was no hemocoagulase-impregnated absorbable gelatin sponge- related adverse reaction. These findings indicate that posterior laminectomy with hemocoagulase-impregnated gelatin sponge can significantly reduce patients’ postoperative wound drainage and shorten the length of stay.