持续腰大池闭式引流治疗外伤性脑脊液漏46例疗效分析  

Curative effect analysis of 46 cases of traumatic cerebrospinal fluid fistula using closed continuous drainage of cerebrospinal fluid via a lumbar subarachnoid catheter

作　　者：洪健[1,2] 张建宁[3] 

机构地区：[1]天津医科大学研究生院 [2]天津市环湖医院神经外科,天津300060 [3]津医科大学总医院神经外科

出　　处：《中国神经精神疾病杂志》2009年第4期228-230,共3页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的探讨持续腰大池闭式引流术治疗外伤性脑脊液漏的疗效。方法回顾性分析2007年1月至2008年9月经持续腰大池闭式引流治疗的46例外伤性脑脊液漏患者的临床资料。结果40例(86.96%)患者脑脊液漏完全治愈,平均带管时间为8d,无严重并发症,3例(6.52%)合并感染经鞘内注药治愈;6例(13.04%)因堵管重新置管;3例(6.52%)出现神经根刺激症状,拔管后症状消失;4例(8.7%)因复发行手术修补,2例(4.35%)因其他严重合并症死亡。结论应用持续腰大池闭式引流术治疗外伤性脑脊液漏是一种简便、安全、有效的治疗方法。Objective To evaluate the curative effect of closed continuous lumbar subarachnoid drainage on the traumatic cerebrospinal fluid （CSF） fistula. Methods We retrospectively analyzed the clinical data of 46 patients with traumatic CSF fistula, who were treated by closed continuous drainage via a lumbar subarachnoid catheter in our department from January,2007 to September,2008. Results All forty, six patients who had a lumbar subarachnoid catheter placed for closed continuous eerebrospinal fluid （CSF） drainage are presented. Overall, the drain was successful in achieving the cured goal in 40 of 46 （ 86.96% ） cases. The average drain time was eight days. There were no cases of deaths or other se- vere complications. There were three cases （6. 52% ） with intracranial infection that had recovered by intrathecal injection. Six of forty, six （13.04%） catheters required replacement because of catheter obstruction. Transient lumbar nerve root irritation was seen in 3 of 46 （6. 52% ） patients, and all symptoms resolved after drain removal. Four cases （8.7%） were repaired by a surgical operation because of recurrence of fistula. Two cases （4. 35% ） died from severe complications. Conclusions Closed continuous lumbar subarachnoid drainage is a simple, safe, and effective way for the treatment or prevention of CSF fistulas.

关 键 词：腰大池引流 外伤性脑脊液漏 疗效 治疗学 

分 类 号：R651.1[医药卫生—外科学]