脊柱手术后脑脊液漏的原因和处理措施

Cause and treatment measures for patients with cerebrospinal fluid leakage after spinal surgery

目的:分析脊柱手术后脑脊液漏的原因,探讨其处理措施及疗效。方法:收治行脊柱手术患者2 116例,术后发生脑脊液漏21例,其硬脊膜损伤部位分别为颈椎3例,胸椎12例,腰椎6例。根据患者具体情况采取不同处理措施。结果:10例患者手术切口均在3~4 d内停止脑脊液渗出。11例脑脊液漏并颅内感染行腰大池持续引流,脑脊液漏停止,切口愈合后拔出引流管。结论:术后发生脑脊液漏时根据具体情况采取不同处理措施能获得良好的效果,脑脊液漏并椎管内感染时行腰大池持续引流治疗是关键。

Objective:To analyze the cause of cerebrospinal fluid leakage after spinal surgery,and to investigate its treatment measures and effect.Methods:2 116 cases with spinal surgery were selected.Cerebrospinal fluid leakage occurred in 21 cases postoperatively;the location of spinal dural injury was in cervical spine of 3 cases,12 cases of thoracic vertebra,6 cases of lumbar vertebra.Taking different actions based on the specific circumstances of the patients.Results:The cerebrospinal fluid stopped exudation from the 10 patient’s surgical incision all within 3~4 days.Continuous drainage of lumbar cistern in 11 cases with cerebrospinal fluid leakage and intracranial infection,we pulled out the drainage tube after the cerebrospinal fluid leakage stopped and wound healing.Conclusion:Taking different actions depending on the specific circumstances of cerebrospinal fluid leakage occurred after operation can get good results.The lumbar continuous drainage is the key to the treatment of patients with cerebrospinal fluid leakage and infection.