颅底肿瘤切除术后脑脊液漏的诊断与治疗

Diagnosis and treatment of cerebrospinal fluid leak after operation for the skull base tumor.

目的探讨颅底肿瘤切除术后脑脊液漏的诊断和处理措施。方法对25例颅底肿瘤切除术后脑脊液漏患者的临床资料进行回顾性分析。结果大部分术后脑脊液漏患者经漏液糖含量测定即可定性,利用CT脑池造影或MRI检查确定漏口位置;约72%的患者经保守治疗和腰池引流于332d内治愈,6例(24%)并发颅内感染,1例死亡。结论术后早期积极腰椎穿刺引流脑脊液,是预防和处理术后脑脊液漏行之有效的方法;仅少数保守治疗无效者需行手术修补。

Objective To investigate the diagnosis and treatment of cerebrospinal fluid (CSF) leak after operation for the skull base tumor.Methods Clinical data of 25 cases of CSF leak after operation for the skull base tumor were retrospectively analyzed.Results Most patients were diagnosed by chemical analysis of collected sample or radionuclide cisternography.The precise localization of leaks were determined by CT or MRI cisternography.72% cases wese cured between 3 days and 32 days by conservative treatment,and lumbar subarachnoid drainage.6 cases(24%) developed into intracranial infection and one died.Conclusion Continuous lumbar drainage is a safe and highly effective treatment to most CSF leaks following surgery for the skull base tumors.Only a few refractory cases need operative repair.