持续性腰部蛛网膜下腔引流在脊柱手术后脑脊液漏治疗中的应用

    Continued lumbar cerebrospinal fluid drainage for management of cerebrospinal fluid leakage after spine operation

    • 摘要: 目的:探讨持续性腰部蛛网膜下腔引流用于脊柱手术后脑脊液漏处理的疗效。方法:对24例骨科脊柱手术后脑脊液漏的患者进行分组治疗,其中常规治疗组(A组)13例,根据脑脊液的漏出量每天更换敷料1~3次并加压;持续性腰部蛛网膜下腔引流组(B组)11例,在术后发现脑脊液漏后立即行持续性腰部蛛网膜下腔引流。比较2组脑脊液漏消失时间和引流管拔除时间。结果:A组患者脑脊液漏消失时间明显比B组延长(P<0.05),且A组患者引流管拔除时间也比B组明显延长(P<0.05)。A组有2例患者1周后漏出量无减少,追加腰部持续性蛛网膜下腔引流后第2天漏出消失;另2例出现中枢感染。B组无追加治疗及中枢感染。结论:持续性腰部蛛网膜下腔引流是治疗脊柱手术后脑脊液漏的有效方法,值得推广。

       

      Abstract: Objective: To evaluate the effect of continued lumbar cerebrospinal fluid drainage on cerebrospinal fluid leakage after spine operation.Methods: Twenty-four cases of cerebrospinal fluid leakage after spine operation were divided into two groups.Group A (13 cases) were applied wound dressing which was changed 1-3 times every day and performed compression;group B (11 cases) were managed by continued lumbar cerebrospinal fluid drainage.Results: The duration of cerebrospinal fluid leakage and wound drainage in group A were significant longer than that in group B (P<0.05).In group A,2 cases whose cerebrospinal fluid leakage failed to decrease after one week resorted to the therapy of lumbar cerebrospinal fluid drainage,and the cerebrospinal fluid leakage ceased the next day;and 2 other cases in this group were complicated with spinal meningitis.There was no additional treatment or spinal meningitis in group B.Conclusions: Continued lumbar cerebrospinal fluid drainage is an effective therapy for postoperative cerebrospinal fluid leakage after spine operation.

       

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