自发性脑脊液鼻漏内镜术后复发的相关因素分析

Related factors analysis of spontaneous cerebrospinal fluid leak recurrence after endoscope operation

目的:总结和分析自发性脑脊液鼻漏患者的临床特点和治疗方法,探讨影响其内镜术后复发的相关因素。方法:回顾性分析2002-07-2012-07期间收治的58例自发性脑脊液鼻漏患者的临床资料,结合其临床特点,对影响其内镜术后复发的相关因素进行统计学分析。结果:58例患者全部采用经鼻内镜脑脊液鼻漏修补术,随诊3年,共复发20例(34.5%)。经多因素分析发现BMI增高、伴空蝶鞍、伴多发颅底骨质缺损是影响自发性脑脊液鼻漏复发的独立危险因素(P<0.05)。结论:自发性脑脊液鼻漏的复发率较高,需长期随访,BMI增高、伴空蝶鞍、伴多发颅底骨质缺损是影响其复发的独立危险因素,治疗上应针对不同病例实行个体化的方案。

Objective： To Summarize and analyze the clinical characteristics and treatment of patients with spontaneous cerebrospinal fluid rhinorrhea, and to explore the related factors of recurrence. Method：Retrospectively analyze the clinical data of 58 patients of spontaneous cerebrospinal fluid rhinorrhea from July 2002 to July 2012, combined with its clinical characteristics, and statistically analyze the related recurrence factors. Result： Fifty-eight cases were accepted the nasal endoscopic repairment of cerebrospinal fluid rhinorrheak, follow-up 3 years, 20 cases （34.5%） recurred, 1 case recurred in half a year after operation. In the first year,there were 10 cases recurred. In the second year there were 9 cases recurred, and 1 case recurred in the third year. Through multiariable analysis it was found that higher BMI, empty sella and skull base bone defect were the independent risk factors influencing the recurrence of spontaneous cerebrospinal fluid rhinorrhea （P〈0. 05）. Conclusion： The recurrence rate of spontaneous cerebrospinal fluid rhinorrhea is high, needing long-term follow-up. Higher BMI, empty sella, skull base bone defect are independent risk factors of recurrence of the disease, and the treatment should be individualized.