医用臭氧在腰椎后路微创手术中应用探析.docVIP

医用臭氧在腰椎后路微创手术中应用探析 　【摘要】 目的 探讨促进腰椎后路手术伤口愈合的有效方法。方法 23例腰椎退行性病变患者进行后路小切口微创神经根管减压或减压内固定融合，在切口闭合之前对所有病变部位分别进行医用臭氧气体注入。结果 所有患者术中术后均无并发症发生，术后全身炎症反应轻，伤口反应轻，均获一期愈合。结论 采用医用臭氧气体注入手术伤口，在防止腰椎后路手术伤口感染和促进伤口愈合上无疑具有极大的优势，建议推广应用。直视下对次要病变的椎间盘进行臭氧治疗，既简化手术又最大限度保留次要病变椎间盘的结构，是一可行办法。 【关键词】 腰椎;后路微创减压;医用臭氧;伤口愈合 【Abstract】 Objective To review the advantage of medical ozone （O3） in patients undergoing posterior lumbar spine surgery.Methods At a single institution，a retrospective clinical review of 23 patients was conducted. All the patients suffered from degenerative lumbar spinal disorders. They were undergone posterior lumbar spinal decompression，decompression and interbody fusion with segmental instrumentation. Before closing the wound，20ml to 40 ml of 60μg/ml O3 was injected in each disc space and around soft tissue accordingly.Results Twelve males and eleven females were involved （mean age 49.6，ranged 33 to 68 years）. The comorbidity included 4 with hypertension，2 with controlled diabetes mellitus，another 2 with stable previous ischemic cerebral vascular and heart disease. Postoperatively，general reaction included no patient with high temperature. The WBC count and neutrophils returned to normal within one week in all patients. No wound infection was found，and only minor local reaction in the wound. All the patients achieved quick recovery and were discharged home soon. The average follow-up was 6 months （range: 2 to 13 months）. The outcomes were as follows: excellent 70% （16/23），good 30% （7/23），fair and poor 0% （0/23）.Condusion It is safe and convenient to inject O3 in posterior lumbar spine surgery，which would be of great benefit for the wound healing. A further investigation with randomly prospective control study for the O3 in spine surgery should be conducted. 【Key words】 Lumbar spine; posterior spinal decompression; medical ozone; wound healing 经过10余年的临床观察，医用臭氧（O3）治疗已经取得巨大的成就，被认为是至今唯一没有毒副作用的治疗方法。它在退行性骨关节病以及腰椎间盘病变的治疗上取得了满意的效果［1～4］。然而能否将O3应用于防止手术伤口感染，促进伤口愈合，至今未见报道。我们从2007年6月开始对腰椎