腰椎管狭窄症患者行硬膜外腔导管松解联合神经根孔外韧带剥离术后并发脑脊液漏的护理

Nursing Care of Lumbar Spinal Stenosis Patients Undergoing Epidural Space Percutaneous Adhesiolysis Combined with Extraforaminotomy Ligament Resection and Caudal Epidural Injections and Complicated with Cerebrospinal Fluid Leakage

目的探讨硬膜外腔导管松解联合神经根孔外韧带剥离治疗腰椎管狭窄症及术后并发脑脊液漏的护理体会。方法分析我科收治的行硬膜外腔导管松解联合神经根孔外韧带剥离术后并发脑脊液漏的腰椎管狭窄症患者的护理过程,总结护理经验。结果采用头低脚高仰卧位休息并加压包扎伤口后,所有患者脑脊液漏均在3～5天停止,伤口愈合,未出现颅内感染及脑脊液囊肿等严重并发症。结论硬膜外腔导管松解联合神经根孔外韧带剥离治疗腰椎管狭窄症术后并发脑脊液漏的处理和预防都很重要。对患者给予严密观察和精心护理,采用体位引流,局部加压包扎,充分补液及抗感染治疗,可取得良好的疗效。

Objective To explore the nursing effect on lumbar spinal stenosis patients undergoing epidural space percutaneous adhesiolysis combined with extraforaminotomy ligament resection and caudal epidural injections complicated with cerebrospinal fluid leakage. Methods The nursing experience of spinal stenosis patients undergoing epidural space percutaneous adhesiolysis combined with extraforaminotomy ligament resection and caudal epidural injections and complicated with postoperative cerebrospinal fluid leakage were analyzed retrospectively. Results By placing the patients in the trendelenburg position and supine rest with pillow underlay oppression the lumbar, all cases were cured in 3 to 5 days, and no unhealing incision and central nervous system infection and cerebrospinal fluid cyst occurred. Conclusions The postoperative cerebrospinal fluid leakage after lumbar spinal stenosis surgery is relatively common. Both treatment and prevention are very important. Good clinical effect can be achieved with postural drainage, compression bandaging, adequate rehydration and antibiotic therapy, as well as close observation and intensive care.