经颅手术修补外伤性脑脊液漏

Transcranial surgical repair of traumatic cerebrospinal fluid leakage

目的探讨经颅手术修补外伤性脑脊液漏的术前定位、手术方法及疗效。方法对2009年1月至2011年9月间18例外伤性脑脊液漏患者资料进行回顾性分析;包括术前检查、手术方式、术后疗效及随访情况。结果急诊手术一期修补12例,术后脑脊液立即停止漏出6例,术后明显减少且2～4 d内停止漏出5例,术后死亡1例;延迟性脑脊液漏修补6例,术后漏出全部停止;所有出院患者随访均无复发。结论术前准确定位漏口,选择合适的手术方法可使外伤性脑脊液漏的修补获得较好的临床疗效。

Objective To explore preoperative localization, operative procedure and efficacy of transcmnial surgery to repair traumatic ce- rebrospinal fluid leakage. Methods The clinical data of 18 patients with traumatic cerebrospinal fluid leakage during January 2009 to September 2011 were retrospectively analyzed. Results Among emergent surgical repair of 12 cases, the leakage was immediately stopped in 6 cases, the leakage was gradually stopped within 2 - 4 days in 5 cases, and one case died of cerebral edema. Six patients with delayed cerebrospinal fluid leakage were repaired, and the leakage in all patients had been stopped after the operation. All discharged patients were followed up without recur- rence. Conclusion Accurate positioning of the porthole of leakage before operation and selection of appropriate surgical procedure to repair trau- matic cerebrospinal fluid leakage can obtain better clinical effectiveness.