低温医用生理盐水在开颅术骨瓣打孔中的应用研究

Research on the application of low-temperature medical saline to bone flap drilling in craniotomy

目的探索一种减少骨屑骨沫飞溅、降低钻孔骨温的方法,为提高手术安全性、减少骨损伤提供临床科学依据。方法选取在常德市第一人民医院2022年1月至2024年6月择期开颅手术患者共62例为研究对象,根据随机数字表分为对照组和改良组,改良组32例,对照组30例。通过比较两组钻头表面温度、飞沫台面面积和钻孔术者面部PM2.5值,分析低温医用生理盐水在开颅术骨瓣打孔过程中的可行性和优点。结果改良组钻头表面温度(29.19±5.69)℃低于对照组(38.21±6.69)℃;改良组骨屑骨沫飞溅台面圆面直径(8.28±1.21)cm小于对照组(21.78±7.21)cm;钻孔术者面部PM2.5值,改良组(0.16±0.08)μg/m^(3)低于对照组(0.21±0.04)μg/m^(3),两组之间差异均有统计学意义(P<0.01)。结论低温医用生理盐水有利于降低开颅术骨瓣打孔钻头温度,减小骨屑骨沫飞溅面积,减小钻孔术者面部PM2.5值,提高手术安全性、减少钻孔骨损伤。

Objective To explore a method of reducing bone debris and foam splashing,lowering drilling bone temperature,thus providing a clinical scientific basis for improving surgical safety and reducing bone damage.Methods A total of 62 patients who underwent elective craniotomy surgery at the First People's Hospital of Changde City from January 2022 to June 2024 were selected as the study subjects and randomly divided into two groups:a modified group of 32 patients and a control group of 30 patients.By comparing the surface temperature of two sets of drill bits,the droplet table area,and the PM2.5 value on the face of the driller,the feasibility and advantages of low-temperature medical physiological saline in bone flap drilling during craniotomy were analyzed.Results The surface temperature of the bit in the modified group was significantly lower than that of the control group(29.19±5.69)℃VS(38.21±6.69)℃(P<0.01).The diameter of the circular surface of the countertop where bone chips and foam were splashed was significantly smaller in the modified group than the control group(8.28±1.21)cm VS(21.78±7.21)cm(P<0.01).The PM2.5 value on the face of patients undergoing drilling was significantly lower in the modified group than the control group(0.16±0.08)μg/m^(3) VS(0.21±0.04)μg/m^(3)(P<0.01).Conclusion Under low-temperature medical physiological saline,it is beneficial to reduce the temperature of the bone flap drilling bit during craniotomy,decrease the area of bone debris and foam splashing,reduce the facial PM2.5 value of the drilling operator,improve surgical safety,and reduce drilling bone damage.