脑脊液漏的诊断和治疗

Diagnosis and treatment of cerebrospinal fluid leakage

目的探讨脑脊液漏的规范化诊断和治疗方法以改善患者预后。方法回顾性分析我院自1994年1月-2007年3月收治的75例脑脊液漏的病例资料，其中鼻漏51例，耳漏9例，切口或伤口漏15例；外伤性漏39例，手术后漏32例，自发性漏4例。23例通过体位休息和药物治疗治愈，16例通过脑脊液引流和（或）伤口局部处理获愈；手术治疗36例，其中开颅修补17例，颅外修补17例，分流5例（其中3例为修补术后再行分流）。结果治愈64例，好转10例，死亡1例。结论规范化的诊断、治疗方案有助于提高脑脊液漏的治愈率，减少并发症。

Objective To investigate standard diagnosis and treatment of cerebrospinal fluid （CSF） leakage to improve the prognosis of the patients. Methods A retrospective study was done on 75 patients with CSF leakage from January 2004 to March 2007 in our hospital. There were 51 patients with rhinorrhea, nine with otorrhea and 15 with wound/incision leakage. Of all, 39 patients had traumatic leakage, 32 postoperative leakage and four spontaneous leakage. In the study, 23 patients were cured by position resting and drug therapy and 16 by cerebrospinal fluid drainage and/or wound debridement but 36 were treated with surgeries including craniotomy repair in 17, extracranial repair in 17 and CSF shunt in five （three received CSF shunt after repair）. Results Of all, 64 patients were cured, 10 gained im- provement but one died. Conclusion Standard diagnosis and treatment of CSF leakage helps improve cure rate and reduce complications.