脊柱外科术后脑脊液漏的诊断及处理  

Diagnosis and management of cerebrospinal fluid leakage after spinal surgery

作　　者：李长文[1] 李志钢[1] 宋建东[1] 李停[1] 李海东[1] 

机构地区：[1]湖北省新华医院脊柱外科,湖北武汉430015

出　　处：《生物骨科材料与临床研究》2011年第5期61-64,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨脊柱术后脑脊液漏的诊断及处理方法。方法回顾性分析2010年1月~2011年6月脊柱外科手术后出现脑脊液漏的7例病人资料,男4例,女3例,年龄34~64岁,平均48岁,发生于颈椎3例,其余4例均见于腰椎。结果 5例经修补硬脊膜、严密缝合、卧床休息、延长引流时间等愈合,1例拔管后出现脑脊液囊肿并发皮下感染,经伤口加压、抗炎、反复穿刺抽液治愈,1例术后1月复查时发现脑脊液囊肿并低颅压综合征,经再次置管引流治愈。结论术后引流液的量及颜色、术后症状的观察对诊断脑脊液漏至关重要,经积极的保守治疗均能治愈。Objective To investigate the diagnosis and management of cerebrospinal fluid leakage （ CSFL ） after spinal surgery. Methods A total 7 cases （ 4 males, 3 females ）were complicated with CSFL after spinal surgery in our department from Jan 2010 to Jun 2011. The average age of the patients was 48 years （ range from 34 to 64 years ）. There were 3 cases of CSFL occurred in cervical vertebrae, others occurred in lumbar vertebrae. Results 5 cases acquired wound healing with dural repair,tight suture,bed rest and extended drainage, 1 case suffered from cerebrospinal fluid cyst and subcutaneous infection after removing the drainage tube, and which was healed with pressure wound, antibiotic therapy and repeated as- piration, another one case suffered from cerebrospinal fluid cyst and intracranial hypotension syndrome, which was healed with drainage again. Conclusion The volume, color of the drainage fluid and the postoperative symptom were the key points to diagnose CSFL, and which could be cured with active expectant treatments.

关 键 词：脊柱手术 脑脊液漏 并发症 

分 类 号：R687.3[医药卫生—骨科学]