摘要
目的探讨用不同方法处理腰椎手术后脑脊液漏的临床疗效。方法对30例腰椎手术后脑脊液漏的患者进行分组治疗,其中基本方法组(A组)30例,延长切口引流管留置时间(B组)20例,经腰蛛网膜下隙置管引流(C组)5例,术后立即经腰蛛网膜下隙置管引流(D组)4例,硬膜外血斑修补法(Maycock法)(E组)3例,手术修补硬脊膜法(F组)7例,比较6组患者并发症出现例数、脑脊液漏停止时间、切口愈合率等指标。结果 A组:10例(33.3%)获得切口愈合,脑脊液漏于术后平均15d消失,2例出现并发症。B组:12例(60.0%)获得切口愈合,脑脊液漏于术后平均18.5d消失,4例出现并发症。C组:5例(100%)获得切口愈合,脑脊液漏消失时间和引流时间平均8.0d,无并发症出现。D组:4例(100%)获得切口愈合,脑脊液漏消失时间平均1.0d,引流时间平均6.0d,无并发症出现。E组:3例(66.6%)获得切口愈合,脑脊液漏消失时间平均3.5d,1例无效,无并发症出现。F组:7例(100%)获得切口愈合,无并发症出现。结论若术中硬脊膜修补不满意,在手术结束时,应立即行经腰蛛网膜下隙置管引流。若术后发现脑脊液漏,尽早行经腰蛛网膜下隙置管引流,效果良好。
Objective To study the different clinical efficacy of six treatments for cerebrospinal fluid(CSF for short) leakage after posterior lumbar operation.Methods 30 patients were classified into 6 groups according to different treatments.30 patients in group a were treated by general method.20 patients in group b underwent prolonging wound drainage.5 patients in group c underwent lumbar percutaneous subarachnoid CSF drainage.4 patients in group d underwent lumbar percutaneous subarachnoid CSF drainage immediately after operation.3 patients in group e underwent method-maycock.group f underwent repairing endorhachis after operation.Then,the number of patients with complications,off-time of CSF leakage,incision healing rate were be analysed.Results In group a,10 patients(33.3%) acquired wound healing,the average CSF leakage duration was 15 days postoperatively,and 2 patients had complications.In group b,12 patients(60%) acquired wound healing,the average CSF leakage duration was 18.5 days postoperatively,and 4 patients had complications.In group c,5 patients(100%) acquired wound healing,the average CSF leakage duration was 8 days postoperatively,and no one had complication.In group e,3 patients(66.6%) acquired wound healing,the average CSF leakage duration was 3.5 days postoperatively,and no one had complications.In last group,7 patients(100%) acquired wound healing,and none of them had complication.Conclusion if the intraoperative repair of endorhachis was not satisfied,lumbar percutaneous subarachnoid CSF drainage were undergone immediately after operation.If the postoperative CSF leakage were found,lumbar percutaneous subarachnoid CSF drainage should undergo as soon as possible.Then it will obtain significant curative effect.
出处
《四川医学》
CAS
2012年第11期1957-1959,共3页
Sichuan Medical Journal
关键词
腰椎
后路手术
脑脊液漏
治疗方法
lumbar
posterior approach
cerebrospinal fluid(CSF)
treatment
