早期腰大池引流术治疗急性颅脑创伤致外伤性脑脊液漏

Early lumbar cistern drainage for treatment of traumatic cerebrospinal fluid leakage induced by acute traumatic brain injury

目的探讨早期腰大池引流术治疗急性颅脑创伤致外伤性脑脊液漏的临床疗效。方法外伤性脑脊液漏患者60例,随机分为早期腰大池引流组(观察组)和保守治疗组(对照组),每组30例,观察组除住院后24h内行腰大池引流术外,其余治疗措施同对照组。观察比较2组脑脊液漏停止时间、2周内临床治愈率和颅内感染率。结果脑脊液漏停止时间观察组为(5.0±0.9)d,对照组为(10.0±1.8)d,观察组明显早于对照组(P<0.05)。2周内观察组30例(100.0%)均临床治愈,对照组临床治愈23例(76.7%),观察组2周内治愈率明显高于对照组(P<0.05)。观察组未出现颅内感染,对照组4例(13.3%)出现颅内感染,观察组颅内感染率明显低于对照组(P<0.05)。结论早期腰大池引流术治疗外伤性脑脊液漏能明显缩短脑脊液漏时间,提高2周内脑脊液漏的临床治愈率并降低颅内感染率。

Objective To investigate the curative effect of early lumbar cistern drainage for treatment of traumatic cere- brospinal fluid leakage induced by acute traumatic brain injury. Methods A total of 60 cases with traumatic cerebrospinal flu- id leakage were randomly divided into early lumbar cistern drainage group （observation group） and conservative treatment group （control group）, with 30 cases in each group. Lumbar cistern drainage was performed within 24 hours after hospitaliza- tion in observation group, and other treatment were as the same as control group. The eerebrospinal fluid leakage stopping time, the clinical curative rate within 2 weeks and the intracranial infection rate were compared. Results The cerebrospinal fluid leakage stopping time of observation group was （5.0 ± 0.9 ） d, and the control group was （ 10.0 ± 1.8 ） d, the cerebro- spinal fluid leakage stopping time of observation group was significantly earlier than that of control group （ P 〈 0.05 ）. All of 30 cases（ 100.0% ）in observation group were cured, and 23 eases （76.7%） in control group were cured within 2 weeks, the clinical curative rate of observation group was significantly higher than that of control group （ P 〈 0.05 ）. There was not any in- tracranial infection case in observation group, 4 cases （13.3%） occurred intracranial infection in control group, the intracra- nial infection rate of observation group was significantly lower than that of control group （ P 〈 0.05 ）. Conclusion Early lum- bar cistern drainage for treatment of patients with traumatic cerebrospinal fluid leakage can significantly shorten the time of leakage, improve the clinical curative rate within 2 weeks and reduce the intracranial infection rate.