桥小脑角区肿瘤术后隐匿性脑脊液漏临床分析

Clinical analysis of latent cerebrospinal fluid leakage after cerebllopontine angle tumor surgery

目的分析49例桥小脑角（CPA）肿瘤术后隐匿性脑脊液漏（CSFL）患者诊断与治疗方法。方法回顾性分析山东大学附属省立医院2006年1月～2013年1月收治49例CPA肿瘤术后隐匿性CSFL患者，保守治疗32例，手术治疗17例，比较保守治疗与手术治疗患者住院时间、总住院费用、治愈率及复发情况。结果随访6～35个月，平均（16．50±1．10）个月。保守治疗组与手术治疗组总住院费用有统计学差异（t=13．07，P〈0．01）。首次保守治疗成功率为93．75％（30／32），高于普通CSFL的治愈率；手术治疗首次治愈率为82．35％（14／17）；两组住院时间与首次治愈卒无统计学差异。结论在CPA肿瘤术后隐匿性CSFL病例中，SPECT扫描在诊断中并非必需．除非患者选择手术治疗．规范的保守治疗比手术治疗曼具优势。

Objective To analyze the diagnosis and treatment of 49 cases of latent CSFL after cerebllopontine angle （CPA） tumor surgery. Methods A retrospective analysis was made on the clinical data of 49 cases of latent CSFL after CPA tumor surgery admitted and treated by Shandong Provincial Hospital Affiliated to Shandong University from January 2006 to January 2013, among which conservative treatment was applied in 32 cases while 17 received opera- tion. The hospital stays, hospital costs, cure rates and relapse rates of conservative and surgical treatments were analyzed and compared. Results The cases were followed up for 6 to 35 months （mean, 16.50 ± 1.10 months）. Average hospital costs had significant difference （ t = 13.07, P 〈 0.01 ）. The success rate of first conservative treatment was 93.75% （30/32）, which was obviously higher than the cure rate of common-type CSFL. The success rate of first operation was 82.35% （14/17）. The cure rates of the first treatment and average hospital stays in both treatment groups showed no statistical significance. Conclusion In the cases of latent CSFL after CPA tumor surgery, SPECT technolo- gy is not necessarily applied in the diagnosis, unless the patients choose surgical treatment. Standard conservative treat- ment shows greater superiority to surgical treatment.