文章摘要

胶原蛋白海绵预防椎间孔镜治疗腰椎管狭窄症术后并发症的价值

作者: 1刘剑锋, 2蒙娜, 3李坤, 4王荣霞, 1张宝琦
1 秦皇岛市第二医院创伤骨科,河北 秦皇岛 066600
2 秦皇岛市第二医院妇科,河北 秦皇岛 066600
3 秦皇岛市第二医院手足科,河北 秦皇岛 066600
4 秦皇岛市第二医院耳鼻喉科,河北 秦皇岛 066600
通讯: 刘剑锋 Email: sis8686@163.com
DOI: 10.3978/j.issn.2095-6959.2021.07.021

摘要

目的:探讨胶原蛋白海绵预防椎间孔镜治疗腰椎管狭窄症术后并发症的价值。方法:选择2017年2月至2019年6月秦皇岛市第二医院诊治的78例腰椎管狭窄症患者,根据随机数字表法分为观察组与对照组,每组39例。所有患者给予椎间孔镜治疗,观察组在此基础上在术后使用胶原蛋白海绵覆盖创面,记录两组术后并发症发生情况。结果:所有患者顺利完成手术,两组手术时间、术中出血量差异无统计学意义(P>0.05);观察组术后引流量、术后卧床时间、术后住院时间均显著少于对照组(P<0.05)。观察组术后7 d的肺部感染、切口感染、吻合口瘘、脑脊液漏等并发症发生率为5.1%,显著低于对照组的30.8%(P<0.05)。两组术后3 d的红细胞计数、血红蛋白水平均低于术前1 d,且观察组高于对照组,差异均有统计学意义(P<0.05)。观察组术后1、3与7 d的疼痛VAS评分均显著低于对照组(P<0.05)。观察组术后6个月的腰椎功能优良率为94.9%,显著高于对照组的74.4%(P<0.05)。结论:胶原蛋白海绵能有效预防椎间孔镜治疗腰椎管狭窄症术后并发症的发生,促进患者康复及腰椎功能恢复,有利于缓解患者术后疼痛,加快红细胞计数、血红蛋白恢复正常。
关键词: 胶原蛋白海绵;椎间孔镜;腰椎管狭窄症;并发症;疼痛

Efficacy of collagen sponge in preventing postoperative complications of lumbar spinal stenosis treated with intervertebral foraminoscope

Authors: 1LIU Jianfeng, 2MENG Na, 3LI Kun, 4WANG Rongxia, 1ZHANG Baoqi
1 Department of Traumatic Orthopaedics, Second Hospital of Qinhuangdao, Qinhuangdao Hebei 066600, China
2 Department of Gynecology, Second Hospital of Qinhuangdao, Qinhuangdao Hebei 066600, China
3 Department of Hand and Foot, Second Hospital of Qinhuangdao, Qinhuangdao Hebei 066600, China
4 Department of Otolaryngology, Second Hospital of Qinhuangdao, Qinhuangdao Hebei 066600, China

CorrespondingAuthor: LIU Jianfeng Email: sis8686@163.com

DOI: 10.3978/j.issn.2095-6959.2021.07.021

Abstract

Objective: This study explored efficacy of collagen sponge in preventing postoperative complications of lumbar spinal stenosis treated with intervertebral foraminoscope. Methods: From February 2017 to June 2019, a total of 78 patients with lumbar spinal stenosis admitted to our hospital were selected as research objects and were divided into observation group and control group, with 39 cases in each group. All cases were treated with intervertebral foraminoscope, while the observation group was covered with collagen sponge after surgery. The postoperative complications of the two groups were recorded. Results: Operation on all patients were completed successfully. There was no significant difference in the operation time and intraoperative blood loss between the two groups. The postoperative drainage volume, postoperative bed-time, and postoperative hospital stay of patients in the observation group were significantly less than those in the control group (P<0.05). The incidence of complications such as pulmonary infection, incision infection, anastomotic fistula, and cerebrospinal fluid leakage of patients in the observation group at 7 days after operation were 5.1%, which were significantly lower than those in the control group’s 30.8% (P<0.05). The red blood cell count and hemoglobin value at 3d after operation in both groups were lower than those at 1 day before operation. But the observation group were higher than the control group, and the differences were statistically significant (P<0.05). The pain VAS scores of the observation group at 1, 3 and 7 d after operation were significantly lower than those of the control group (P<0.05). The excellent rates of lumbar spine function in the observation group at 6 months after operation were 94.9%, which were significantly higher than the 74.4% in the control group (P<0.05). Conclusion: Collagen sponge can effectively prevent the complications of lumbar spinal stenosis after laparoscopic surgery, promote the rehabilitation of patients and the recovery of lumbar spine function. It is helpful to alleviate postoperative pain, accelerate the red blood cell count, and restore hemoglobin to normal.
Keywords: collagen sponge; intervertebral foramen; lumbar spinal stenosis; complications; pain