脊柱肿瘤术中硬脊膜缺损的处理

Proper Management of Dural Defect during Operation of Spinal Tumors

目的探讨脊柱肿瘤手术术中硬脊膜缺损的处理方法。方法对蚌医二附院2008年2月-2010年8月脊柱肿瘤手术术中出现硬脊膜缺损的13例患者的临床资料进行总结分析。其中男性5例,女性8例;年龄46～74岁,平均年龄63.5岁,脊膜瘤8例、神经鞘瘤3例、椎体转移瘤2例。肿瘤连同受侵硬脊膜切除后硬脊膜缺损,采用自身组织填塞、覆盖、紧密缝合、局部加压包扎、持续硬膜外引流的综合治疗方法进行处理。结果 13例患者切口完全愈合,无脑脊液漏、硬脊膜假性囊肿及中枢感染等并发症发生。结论对于术中硬脊膜缺损,采用自身组织填塞、覆盖、紧密缝合、局部加压包扎、持续硬膜外引流,可有效防止术后并发症的发生。

Objective To probe the proper management of dural defect during the spinal tumor operation.Methods Retrospectively investigated the clinical records of 13 patients with dural defect during the spinal tumor operation from Dec 2008 to Aug 2010 in our hospital.There were 5 males and 8 females.The age was 46 to 74 years old（mean 63.5 years old）.There were 8 cases of spinal meningioma,3 cases of schwannoma,and 2 cases of vertebral metastasis.Results All incisions got heal up without leakage of cerebrospinal fluid,pseudomeningocele or central nervous system infection.Conclusion For the dural defects in the operation of spinal tumors,tamponade with own tissues,covering,tight stitching,pressure bandage and continuous drainage can effectively prevent from the complications.