终池置管持续引流治疗脑外伤术后脑脊液漏伴颅内感染

Continuous drainage via a lumbar catheter in terminal cistern for treatment of postoperative cerebrospinal fluid leakage accompanied by intracranial infection

目的：探讨脑外伤术后脑脊液漏伴颅内感染的有效治疗方法。方法：10例脑外伤术后脑脊液切口漏伴颅内感染患者,采用腰椎穿刺终池置管持续外引流治疗。结果：10例经引流1-2天后脑脊液漏明显减轻,脑脊液切口漏伴感染治愈者9例,随访6个月无复发脑脊液漏者,1例脑实质感染,手术切除感染灶,颅内感染及脑脊液切口漏仍难以控制而病死。结论：外伤性脑脊液漏伴颅内感染,在全身应用敏感抗生素的前提下,采用终池置管持续外引流治疗,可明显提高疗效。

Objective：To explore the effective therapeutic strategy of cerebrospinal fluid fistula with intracranial infection in brain. Methods：Ten patients with cerebrospinal fluid（CSF） fistula and intracranial infection in brain admitted to our hospital in past 7 years were treated with lumbar puncture and continuous external drainage, and the relevant clinical material were reviewed and analyzed. Results：The leakages in 10 patients with CSF fistulae accompany by intracranial infection were reduced 1 to 2 days after continuous drainage and 9 patients were cured. The follow-up of 6 months proved no CSF fistula. One of patients suffered from brain infection. Although the infection tissue was resected,the intracranial infection and leakage of cerebrospinal fluid were not under the control. The patient was died at last. Conclusions： The continuous lumbar external drainage is a safe and effective method for curing CSF fistula with intracranial infection in brain.