Release date: 2007-09-03
Application of Fu Aile medical glue in neurosurgery. Department of Neurosurgery, General Hospital of People's Liberation Army, Meng Xianghui, Xu Bainan, Wei Shaobo (Postal Code 100853), Department of Neurosurgery, North China Petroleum General Hospital, Wang Runhui (zip code 062552). Medical glue is widely used in neurosurgery. From March 2006 to January 2007, 280 cases of Fouile medical glue were applied in neurosurgery. The results were satisfactory. The following clinical data were available: 110 males and 170 females, aged 9-79 years old, with an average of 42.87. year old. There were 74 cases of supratentorial craniotomy, 21 cases of meningioma, and 53 cases of glioma. There were 19 cases of skull base lesions, 16 cases of meningioma, 2 cases of chordoma, and 1 case of abnormal proliferation of skull fibers. There were 111 cases of transsphenoidal approach, 98 cases of pituitary tumor, and 13 cases of Lacto's cyst. There were 62 cases of craniotomy under the curtain, 19 cases of cerebellar tumor, 28 cases of cerebellopontine angle tumor, 4 cases of trigeminal neuralgia, 2 cases of hemifacial spasm, and 9 cases of cerebellar tonsillar mandibular deformity. 4 cases of brain trauma. 10 cases of spinal canal surgery. Usage: After suturing the dura mater on the tumor, the Fu Aile medical glue is applied to the suture. After a small amount of muscle or fascia is applied to the suture, the leak is blocked. The meningioma is repaired after the hard film is removed. After the glioma is enlarged and repaired, the Fuerle medical glue is applied to the suture. In the supratentorial craniotomy, the hemorrhage of the arachnoid granules on the dura mater can be fixed with a gelatin sponge and then fixed with a small amount of Fule Medical glue. For the reconstruction of the skull base with anterior skull base surgery, the self-made fascia or artificial dura mater is used to repair the dura mater. After transsphenoidal approach for pituitary adenoma surgery, the tumor is resected with gelatin sponge to stop bleeding, and then the syringe is used to extract the Fuelle medical glue and then attached to the long needle to coat the gelatin sponge. If the cerebrospinal fluid leaks during surgery, it will be coated with blessing. Gelatin sponge or fat from Philharmonic Medical Glue is stuffed and plugged. After the operation of the posterior fossa lesion, the dura mater is not tightly treated with muscle or fascia and coated with Fuerile medical glue at the leak. After the operation of the posterior fossa lesion, the repair of the dura mater with the autologous fascia or artificial dura mater is performed at the suture. Apply a little Fu Aile medical glue. After the acoustic neuroma surgery removes the internal auditory canal, the inner auditory canal is filled with small muscles coated with medical glue for preventing cerebrospinal fluid leakage. The small bone flap is fixed with medical glue. Spinal canal surgery after dural suture with medical glue applied to the suture, paravertebral venous plexus such as bleeding more with gelatin sponge pressure to stop bleeding and then apply a little medical glue. RESULTS: Forty-six cases of supratentorial lesions were treated with fascia or artificial dura mater for repairing the dura mater and Fuerle medical gel. There was no subcutaneous effusion caused by cerebrospinal fluid leakage. 111 patients underwent transsphenoidal approach for postoperative gelatin. Sponge and / or fat with Fu Aile medical glue did not appear obvious bleeding or cerebrospinal fluid leakage in the tumor cavity; 19 cases of anterior cranial fossa surgery after the application of fascia, muscle or artificial dura mater with Fu Aile medical glue used to repair no cerebrospinal fluid Leakage; 37 cases of posterior fossa lesions were treated with fascia, muscle or artificial dura mater and Fuerile medical glue without subcutaneous effusion. One case of acoustic neuroma was removed from the internal auditory canal to prevent cerebrospinal fluid leakage. A small piece of muscle coated with medical glue is used to fill the inner auditory canal. Four patients with traumatic brain injury were treated with fascia or artificial dura mater to repair the dura mater and use the subcutaneous effusion caused by leakage of cerebrospinal fluid. There were no skull floating or necrosis in 2 cases of fixed skull. After the other operations, the durum medical suture is applied to the suture or the gelatin sponge is placed on the suture, and then the medical glue is applied. Ten cases of spinal canal disease were treated with dural suture and Fuerle medical glue without epidural hematoma or subcutaneous fluid. Discussion Fule's medical glue consists of y-cyanoacrylate n-octyl ester (N-OCA) and а-n-butyl cyanoacrylate (N-BCA). Removed 502, plexiglass, Freon and other additives in the second generation of medical adhesive formulations. Under the action of anion, the curing time is 2-6 seconds. The electron microscope observes that the film is tightly embedded with the tissue, and the fiber with a diameter of 2-3 microns is entangled to form a network structure, preventing the passage of red blood cells, and human thrombin and fibrin. The original interaction produces a blood coagulation state fibrin, which can block small blood vessel bleeding and oozing blood, and immediately stop bleeding. The mesh structure can also play a sealing role, so Fuai Le medical glue can be blocked in neurosurgery or Hemostasis. Most of the patients with pituitary tumors use transsphenoidal surgery. After surgery, gelatin sponge is used to stop bleeding and a small amount of Fu Aile medical glue is used to stop bleeding. At the same time, it can prevent further saddle contents, and use gelatin sponge for cerebrospinal fluid leakage during surgery. Or fat coated with Fule's medical glue padding to prevent leakage. The supratentorial meningioma is resected after the repair of the dura mater or after the glioma is enlarged to repair the dura mater. After the suture is applied to the suture, the cerebrospinal fluid leakage can be prevented. Post-cranial fossa tumor, cerebellar tonsil mandibular malformation, trigeminal neuralgia and other operations after surgery due to dura mater is not strict, sometimes there will be subcutaneous effusion caused by cerebrospinal fluid leakage, it is very difficult to handle, often need lumbar puncture drainage Cerebrospinal fluid, local puncture compression dressing, individual severe cases need to be re-surgically repaired. After the posterior fossa surgery, the dural suture is not strict. We use muscles or fascia to block the leak and then apply Fu Aile medical glue. It is necessary to expand the case of repairing the dura. After suturing the dura mater, suture the suture with Fu Aile medical glue. Our case did not have epidural effusion after the above treatment. For patients with acoustic neuroma to remove the internal auditory canal, cerebrospinal fluid leakage may be applied to the auditory canal with muscles to prevent postoperative cerebrospinal fluid leakage. In the cerebral trauma surgery, the muscle or fascia of the Fuai medical glue is used to stop bleeding after venous sinus injury. The hemorrhage of the arachnoid granule on the dura mater in the brain tumor operation can be firstly applied with a gelatin sponge to stop bleeding and a small amount of Fuerle medical glue is applied. After suturing the tumor on the on-screen tumor or repairing the dura mater with fascia and artificial dura mater, the suture can be used to prevent cerebrospinal fluid leakage. Skull base reconstruction is of great significance in the operation of skull base. In order to prevent postoperative cerebrospinal fluid leakage, the cranial fluid is repaired with muscle, fascia, periosteum or artificial dura mater and Fuerle medical glue. Skull reconstruction can also be used for medical treatment. The bone used for the fixation of the glue. After craniotomy sutured the dura mater after the reduction of the bone flap can be fixed with Fu Aile medical glue. After the bone flap is drilled, the bone foam is retained. After the bone flap is restored, the bone hole is backfilled with bone foam and the bone hole can be eliminated by bonding with Fuleile medical glue. In the operation of spinal canal tumor, the paraspinal venous plexus hemorrhage is compressed with gelatin sponge and then coated with a little Fu Aile medical glue to stop bleeding. Suture the dura mater or enlarge the repaired dura mater and use the Fu Aile medical glue to smear the suture to prevent cerebrospinal fluid leakage. Through clinical application, we believe that Fuai Le medical glue has the outstanding advantages of high adhesive strength and short time in intracranial energy degradation, so it has sealing, plugging, hemostasis, adhesive dura mater and fixation. Skull fragments prevent cerebrospinal fluid leakage and have no adverse reactions. In the application process, pay attention to less dosage, thinner glue, accurate and rapid movement, and good clinical results. [Author] Meng Xianghui male 1965.7 Yuesheng MD, deputy chief physician
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