腰椎间盘术后脑脊液漏的防治

Prevention and treatment of cerebrospinal fluid leakage in lumbar disc surgery

目的 分析腰椎间盘手术中硬脊膜损伤的原因 ,探讨术后脑脊液漏的防治措施。方法 回顾 1997年 3月～ 2 0 0 1年 10月发生的 19例腰椎间盘术后脑脊液漏的临床资料并进行分析总结。结果 除 1例保守治疗无效须重新修补硬脊膜外 ,其余经保守治疗而痊愈。结论 防治脑脊液漏的主要措施包括术前充分的准备 ,术中仔细操作 ,及时对硬膜损伤进行修补 ,术后采取正规的保守治疗。大多数脑脊液漏可以保守治愈 。

Objective To analyze the causes of dual damage during lumbar disc surgery and to probe the prevention and treatment of cerebrospinal fluid leakage after surgery.Methods Clinical materials of 19 cases suffered from cerebrospinal fluid leakage after surgery from March 1997 to October 2001 were retrospectively analyzed.Result Eighteen out of 19 patients were cured by conservative measurements while one was reoperatived for repairing dura mater.Conclusions The rate of cerebrospinal fluid leakage can be decreased by detailed preoperative preparation and strict operation; repairing dura mater in operation and regular conservative treatment after operation can cure most of cerebrospinal fluid leakage. Few cases failing to conservative treatment need reoperation for repairing dura mater.