人工硬脑膜与自体筋膜用于后颅窝重建术后脑脊液漏的疗效观察

Clinical observations of cerebrospinal fluid wound leakage after posterior cranial fossa craniotomy which using synthetic dural substitute and autologous anadesma in dural closure and reconstruction

目的探讨人工硬脑膜及自体筋膜用于后颅窝硬脑膜修补能否减少术后脑脊液漏。方法回顾性分析165例后颅窝开颅术后病人的临床资料。结果脑脊液漏发生率传统术式组26.9%,人工硬脑膜组10.6%,自体筋膜组8.5%。早期传统术式组的脑脊液切口漏发生率与其他两组相比差异均有统计学意义(P<0.05),而人工硬脑膜组及自体筋膜组脑脊液切口漏发生率则无统计学差异(P>0.05)。结论硬脑膜严密缝合及重建是降低脑脊液漏发生率的正确对策,人工硬脑膜及自体筋膜修补硬脑膜后脑脊液切口漏发生率相比无统计学差异(P>0.05)。人工硬脑膜是可靠的硬脑膜修补替代物,疗效肯定。

Objective To explore whether using the Neuro - Patch or autologous anadesma in dural closure arm reconstruc- tion could reduce the incidence of cerebrospinal fluid wound leakage after the posterior cranial fossa craniotomy. Methods Clinical data of 165 patients with the posterior cranial fossa craniotomy were analyzed retrospectively,including The traditional craniotomy group, Neuro - Patch group, and Autologous anadesma group. The incidence of cerebrospinal fluid wound leak of three groups was reviewed comparatively. Results In the traditional craniotomy group, cerebrospinal fluid wound leakage occurred in 14（26. 9% ） ,compared to the 7 in Neuro - Patch group（ 10. 6% ） ,and 4 in Autologous group （8.5%）. Conclusions Dural watertight suture is the correct therapeutic strategy to reduce the incidence of cerebrospinal fluid wound leakage. There is no difference in the effect of use the Neuro - Patch or autologous anadesma to reduce the incidence rate of this complication. The Neuro - Patch is a reliable dural substitute for repairing the dural defects.