杜永伟 刘真 徐房添 赖光松

[摘要]目的 探讨负压封闭引流（VSD）在胸腰椎后路手术并发脑脊液漏中的临床疗效分析。方法 选择2015年1月～2017年1月我院接诊的胸腰椎后路手术并发脑脊液漏患者30例，在征得患者同意的前提下，根據随机数字表法分成观察组（n=15）和对照组（n=15）。观察组患者采用VSD治疗方案，对照组采用常规治疗方案。比较两组患者的临床治疗效果。结果 ①治疗后，观察组患者住院时间为（8.43±1.05）d，明显低于对照组的（11.54±0.15）d；观察组患者的伤口愈合时间为（18.1±1.4）d，明显低于对照组的（31.2±2.1）d，差异均有统计学意义（P<0.05）。②观察组患者的并发症发生率为0.0%，比对照组（40.0%）更低，差异有统计学意义（P<0.05）。结论 将VSD用于胸腰椎后路手术并发脑脊液漏患者临床治疗，可有效缩短患者的住院时间，减少并发症发生风险，提高预后效果，值得临床借鉴。

[关键词]胸腰椎后路术；负压封闭引流；脑脊液漏；临床疗效

[中图分类号] R687.3 [文献标识码] A [文章编号] 1674-4721（2018）4（a）-0080-03

Analysis on the clinical efficacy of negative sealing drainage in the treatment of posterior thoracolumbar surgery complicated with cerebrospinal fluid leakage

DU Yong-wei LIU Zhen XU Fang-tian LAI Guang-song

Department of Orthopedics，the First Affiliated Hospital of Gannan Medical College，Jiangxi Province，Ganzhou 341000，China

[Abstract]Objective To investigate the clinical efficacy of negative sealing drainage （VSD） in the treatment of posterior thoracolumbar surgery complicated with cerebrospinal fluid leakage.Methods A total of 30 patients complicated with cerebrospinal fluid leakage who underwent posterior thoracolumbar procedure in our hospital from January 2015 to January 2017 were selected，they were divided into observation group （n=15） and control group （n=15） according to random number table.The observation group was given VSD treatment，and the control group was given conventional treatment.The clinical curative effects were compared between the two groups.Results ①After different methods of treatment，the length of stay in the observation group was （8.43±1.05） d，significantly lower than that of （11.54±0.15） d in the control group；the wound healing time in the observation group was （18.1±1.4） d，significantly lower than that of （31.2±2.1） d in the control group，the differences between the two groups were significant（P<0.05）.②The incidence rate of complications in the observation group was 0.0%，which was lower than that of 40.0% in the control group，there was significant difference between the two groups（P<0.05）.Conclusion The application of VSD in the clinical treatment of patients receiving posterior thoracolumbar surgery complicated with cerebrospinal fluid leakage can effectively shorten the length of stay，reduce the risk of complications and improve the prognosis，which is worthy of application in clinical practice.

[Key words]Posterior thoracolumbar surgery；VSD；Cerebrospinal fluid leakage；Clinical efficacy

近年来，随着脊柱外科手术发展技术的成熟，一些风险系数相对较高、难度系数较大的脊柱手术也逐渐在外科手术中开展，而导致术后脑脊液漏、硬脊膜损伤的发生率也逐渐增高[1]。针对术后脑脊液漏，采取传统的治疗方法均未能取得较好的临床治疗效果。调查研究结果显示，将VSD应用于胸腰椎后路手术并发脑脊液漏患者的治疗可取得更显著的成效[2]。此外，相比较于传统疗法，VSD的临床应用价值更高，能显著缩短患者康复所需的时间，有助于减少患者术后相关并发症的发生风险，可有效提高患者的预后效果[3-4]。本研究以胸腰椎后路手术并发脑脊液漏患者为对象，着重剖析VSD在胸腰椎后路手术并发脑脊液漏中的应用价值，现报道如下。

1资料与方法

1.1一般资料

以2015年1月～2017年1月我院接诊的30例胸腰椎后路手术并发脑脊液漏患者为研究对象，其中包括腰椎结核3例，胸腰椎骨折8例，腰椎管内肿瘤4例，腰椎间盘突出6例，腰椎管狭窄9例。……