脊柱手术中硬脊膜损伤及术后脑脊液漏的处理研究

Treatment of Dural Injury and Postoperative Cerebrospinal Fluid Leakage during Spinal Surgery

目的探讨脊柱手术后脊髓硬膜损伤和术后脑脊液漏的治疗。方法方便选取2014年3月—2018年3月该院行脊髓手术并发脑脊液漏的患者60例作为研究对象。按随机数字表法分为对照组和观察组,每组30例。手术过程中对照组采用直接缝合修补。观察组给予硬脑膜补片,并结合筋膜密封硬间断缝合。比较两组术后并发症发生率。结果对照组发生脑脊液漏19例,占63.33%;观察组发生脑脊液漏5例,占16.67%,说明两组差异有统计学意义(χ2=4.032 8,P<0.05)。结论硬脑膜补片是治疗硬膜外硬膜损伤,预防术后脑脊液漏的有效方法。

Objective To investigate the treatment of spinal cord dural injury and postoperative cerebrospinal fluid leakage after spinal surgery.Methods Sixty patients with spinal cord surgery and cerebrospinal fluid leakage in our hospital from March 2014 to March 2018 were convenient selected as subjects.According to the random number table method,they were divided into control group and observation group,30 cases in each group.The control group was treated with direct suture during the operation.The observation group was given a dural patch and combined with fascia seals for hard interrupted suture.The complication rate were compared between the two groups.Results In the control group,cerebrospinal fluid leakage occurred in 19 cases,accounting for 63.33%;in the observation group,cerebrospinal fluid leakage occurred in 5 cases,accounting for 16.67%,indicating that the two groups were statistically significant(χ^2=4.032 8,P<0.05).Conclusion Dura mater is an effective method for the treatment of epidural dural injury and prevention of postoperative cerebrospinal fluid leakage.