人纤维蛋白黏合剂在显微神经外科手术中的应用

Application of Human Fibrin Glue to Microneurosurgery

目的探讨人纤维蛋白黏合剂在显微神经外科手术中的实际应用方法,提高手术疗效及减少术后并发症。方法对2004年1～6月间我们在10例显微神经外科手术中应用人纤维蛋白黏合剂(HFG)进行回顾性研究。结果(1)用于脑部手术创面止血效果好。(2)术中静脉窦出血,用明胶海绵或止血纱布压迫后加用 HFG,止血效果佳。(3)开颅手术中用 HFG 覆盖硬脑膜,术后第1天,平均引流量明显减少,降低了术后脑脊液漏的发生。(4)用 HFG 加自体骨碎片作顿骨成形术,效果满意。(5)血管显微吻合术中使用 HFG,可减少缝合针数,预防吻合口渗漏。(6)经蝶手术中使用 HFG,可止血利于手术进行,另可行鞍底重建防治术后脑脊液漏。结论人纤维蛋白黏合剂在显微神经外科手术中应用广泛,其使用简便、安全、可靠,提高了手术疗效并减少了术后并发症。

Objective To explore the practical application of human fibrin glue(HFG)to microneurosurgery for enhancing operative effect and reducing postoperative complications.Methods We retrospectively reviewed the concrete conditions of 10 operations to which the HFG was applied from Jan.,2004 to June,2004.Results(1) HFG had excellent effect on preventing bleeding on wounded surface in neurosurgery;(2)Using gelatin sponge or hemostatic gauze plus HFG to press ruptured bleeding venous sinus during the operations had excellent hemostatic effect;(3)Using HFG to cover the cerebral dura mater in craniocerebral operation,the average drainage outflow on the first day after operation obviously decreased and the occurrence rate of eerebrospinal fluid leak also reduced;(4) Using HFG and selfbone fragment in skull reconstructed operations got satisfying effect;(5)In angioanastomosis, using HFG could reduce the amount of sewing to prevent stoma leak.(6)Using HFG in trans-sphenoid operations could stop the oozing with blood and make the operative processes smooth.Conclusion HFG has a wide use in mieroneu- rosurgery and its convenience,safety and reliability make the operation more smooth,lessening complications.