鼻内镜修补脑脊液鼻漏31例临床分析

Clinical analysis of endoscopic repair of cerebrospinal fluid rhinorrhe

目的：总结经鼻内镜修补脑脊液鼻漏的经验。方法：收集我科2000-2006年经鼻内镜修补脑脊液鼻漏患者31例的临床资料，分析脑脊液鼻漏的病因、手术时机、围手术期的治疗及术中注意事项。结果：31例患者中，一次修补成功有28例，2例经再次修补，1例经第3次修补成功。1例术后并发脑膜炎。随诊6个月～7年，无再发生脑脊液鼻漏。结论：前颅底、鞍底、斜坡处瘘口，除恶性肿瘤引起的鼻漏，最佳的治疗方法是鼻内镜下修补瘘孔。

Objective： To summarize 6 years experiences in endoscopic repair of cerebrospinal fluid rhinorrhe. Methods： The clinical data of 31 cases of endoscopic repair of cerebrospinal fluid rhinorrhe from 2000-2006 year were analyzed retrospectively, including the cause, the operation opportunity, the treatment of peri-operation period and points for attention during the operation of cerebrospinal fluid rhinorrhe. Results： 28 cases were successfully repaired by endoscopy. The successful rates were 90.3% （28/31）. Two cases needed to be repaired one more. One case needed to be repaired three times. Only one case had complication of cephalitis meningica. No cerebrospinal fluid rhinorrhe was relapsed in all cases from 6 months to 7 years follow-up. Conclusion： The best treating method of rhinorrhe in front bases of skull, bases of saddle and clivus blumenbachii orificium fistulae except malignant tumor is endoscopic repair of fistulous opening.