经皮椎弓根螺钉取内固定术中钉道处理对术后出血影响的研究.

Objective: Exploring the effect of using prefabricated conical absorbable gelatin sponge to fill and remove pedicle screw paths during percutaneous pedicle screw removal and internal fixation surgery on postoperative local bleeding. Methods: From June 2020 to January 2023, our hospital included a total of 68 patients who met the inclusion and exclusion criteria for internal fixation removal after percutaneous pedicle screw surgery. Randomly divided into two groups, the observation group was filled with prefabricated conical absorbable gelatin sponge after removing the pedicle screws, while the control group was only treated with saline irrigation and then left empty. Collect and compare blood laboratory indicators, postoperative incision pain and functional scores, and corresponding imaging examinations of patients before and 3 days after surgery. Results: In the observation group, there was no significant statistical difference in blood routine results between preoperative and postoperative 3 days (P>0.05). The experimental group had significantly better inflammatory factor results than the control group on postoperative 3 days (P<0.05); At the time of dressing change 2 days after surgery, the experimental group was significantly better than the control group in terms of local swelling degree and estimated bleeding volume under ultrasound (P<0.05). There was no statistically significant difference in VAS score and ODI score between the two groups before surgery and 1 day after surgery (P>0.05), but in the comparison 5 days after surgery, the experimental group was significantly better than the control group (P<0.05). All patients did not experience irreparable complications. Conclusion: After percutaneous pedicle screw surgery, the original incision is taken out for internal fixation. Prefabricated conical absorbable gelatin sponge is used to fill the screw path, which can significantly reduce postoperative bleeding, alleviate patient pain, and shorten hospital stay. It is an ideal treatment method and can be promoted for routine application in this type of surgery. [ABSTRACT FROM AUTHOR]