脊柱外科中脑脊液漏的预防和治疗

Prevention and treatment of cerebrospinal fluid leakage in spinal surgery

目的 探讨脊柱外科中脑脊液漏的防治措施.方法 回顾性分析2004年1月至2010年7月发生的30例脊柱手术后脑脊液漏患者的临床资料.颈椎手术6例,胸椎手术4例,腰椎手术16例,骶椎手术4例.术中均发现硬脊膜破裂,行修补或填塞硬脊膜漏口,逐层严密缝合伤口,置管引流,伤口加压包扎,术后卧床休息等综合措施处理.结果 经过术中、术后仔细的处理,30例脑脊液漏患者全部经保守治疗后于6～26d内治愈.结论 通过术中对硬脊膜损伤及时修补或堵塞,术后采取正规的保守治疗措施,绝大多数脑脊液漏均可治愈.

Objective To explore the prevention and treatment of eerebrospinal fluid leakage in spinal surgery＇. Methods A retrospective analysis was performed on the clinical data of 30 patients who suffered from cerebrospinal fluid leakage after spinal surgery between January 2004 and July 2010. The study enrolled 19 males and 11 females at an average age of 50 years. Among these patients,6 received cervical spinal surgery,4 received thoracic spinal surgery,16 had lumbar spinal surgery and 4 were given sacral surgery. Injury of dura mater occurred in all cases during operation. Management included repair or blockage of breach in the dura mater,oversewing every layer of the wound, catheter drainage, compression dressing and bed rest and so on. Results Through careful treatment in the operation and post - operation,all the eases were cured between 6 and 26 days by conservative treatments. Conclusions Ahnost all cerebrospinal fluid leakage can be cured by repairing dura mater or blocking leakage in operation and regular conservative treatment after operation.