吕志刚

[摘要] 目的 探讨在脊柱后路手术合并硬脊膜破裂患者中实施综合处理的临床价值。 方法 将整群选取的2010年1月—2015年1月在该院行脊柱后路手术治疗且伴发硬脊膜破裂的68例病例纳入研究，通过随机对照法将病例等分成两组，对照组34例根据常规标准对症处理，观察组34例实施综合处理模式治疗，研究两组的临床处理情况。 结果 观察组处理后的临床满意度是97.06%，相比对照组的76.47%明显更高，差异有统计学意义（P<0.05）。且观察组的切口愈合时间要相比对照组更短，差异有统计学意义（P<0.05）。并发症的对比，两组发生率相当，差异无统计学意义（P>0.05）。 结论 在脊柱后路手术合并硬脊膜破裂患者中实施综合处理，可有效促进切口愈合，提高患者满意度，并尽量避免发生并发症，整体效果更加理想，适合加强推广。

[关键词] 脊柱后路手术；硬脊膜破裂；综合处理；临床价值

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2015）09（c）-0017-03

[Abstract] Objective To study the clinical value of comprehensive treatment for posterior spinal surgery complicated by endorachis rupture. Methods 68 cases with posterior spinal surgery complicated by endorachis rupture were enrolled into the study and equally divided into two groups， the control group and the observation group in accordance with the randomized controlled method. 34 cases in the control group were given the conventional and standard symptomatic treatment and 34 cases in the observation group were given the comprehensive treatment. And the clinical treatment of the two groups was studied. Results The clinical satisfaction level in the observation group was much higher than that in the control group（97.06% vs 76.47%）， with statistically significant difference（P<0.05）. The incision healing time was much shorter in the observation group than that in the control group， with statistically significant difference（P<0.05）. The incidence of complications of the observation group was similar to that of the control group， the difference in the incidence of complications between the two groups was not statistically significant（P>0.05）. Conclusion For patients with posterior spinal surgery complicated by endorachis rupture， comprehensive treatment can effectively promote the healing of incision， improve the patient satisfaction， prevent the incidence of complications as much as possible with ideal overall effect， so it is suitable for strengthened promotion.

[Key words] Posterior spinal surgery； Endorachis rupture； Comprehensive treatment； Clinical value

脊柱后路手术是现代外科学治疗腰颈椎、胸椎损伤或骨病的重要术式，对恢复患者的脊柱解剖功能十分关键[1]。然而围术期极易诱发硬膜外破裂、脑脊液漏等合并症，给患者预后造成了相当不利的影响。早期有效的临床处理及治疗，对减轻症状、提高患者预后质量至关重要[2-3]。该研究于2010年1月—2015年1月采取综合处理模式对34例患者展开救治与对照分析，实验结果较理想，现报道如下。

1 资料与方法

1.1 一般资料

整群选取的该组68例病例自2010年1月—2015年1月，均行脊柱后路手术治疗，且证实术后合并硬脊膜破裂症状。全体患者在入组前均已签署相关知情文件，表示自愿配合此次研究。通过随机对照法将研究对象等分成两组，观察组34例中，男有18例，女有16例，年龄在25～63岁范围，中位是（43.8±3.7）岁；……