摘要
目的探讨显微内镜椎间盘摘除术(microendoscopic discectomy,MED)术中椎管内出血的应对措施. 方法针对MED术中椎管内不同情况的出血,用电凝、压迫、冲洗、止血药等各种相应的方法应对处理. 结果本组共287例,无一例因椎管内出血中转开放手术.随访4个月～2.5年,平均1年5个月,按MacNab标准近期疗效:优219例,良59例,可7例,差2例. 结论 MED术中,减少腹压、每个步骤均需严格止血、避开曲张静脉处剥离突出椎间盘、用明胶海绵及小脑棉压迫止血、术前术中分别静推'立止血'等,能较好地处理术中椎管内出血,有效的提高手术安全性及治疗效果.
Objective To explore the emergent measures for hematomyelia during microendoscopic discectomy (MED). Methods Different measures, such as electrocoagulation, compression, irrigation, or hemostatic administration, were directed against different types of hematomyelia during MED. Results No conversions to open surgery for hematomyelia were required in all the 287 cases in the study. A follow-up for 4~30 months (mean, 17 months) was carried out. According to the MacNab criteria, excellent results were achieved in 219 cases, good results in 59 cases, fair in 7, and poor in 2. Conclusions Measures for hematomyelia during MED include the decrease of abdominal pressure, strict hemostatic performance, keeping off varicose veins when the protruded intervertebral disc is resected, compression by using gelfoam or styptic cotton, and intravenous administration of thrombin. These measures can effectively improve the surgical safety and the curative effect.
出处
《中国微创外科杂志》
CSCD
2005年第5期374-375,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
MED
腰椎间盘突出症
椎管内出血
MED
Lumbar intervertebral disc herniation
Hematomyelia
