术区持续引流切口愈合后拔管缝合管口治疗脊柱爆裂性骨折术后脑脊液漏疗效观察  

Continuous wound drainage and removing tubes and stitching wound after healing of incision for cerebrospinal fluid leakage following spinal burst fracture operation

作　　者：胡安文[1] 李峰[1] 蒲丹[1] 肖业生[1] 罗光平[1] 杨长远[1] 袁泉 刘洪[1] 向超[1] 朱钧[1] 

机构地区：[1]湖南省怀化市第一人民医院脊柱外科,418000

出　　处：《中国骨与关节损伤杂志》2012年第3期219-221,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的评价术区持续引流、切口愈合后拔管缝合管口治疗脊柱爆裂性骨折术后脑脊液漏的效果。方法对自2004年6月~2010年6月收治的脊柱爆裂性骨折术后脑脊液漏61例采用体位调节、切口加压包扎治疗（A组,20例）,经皮蛛网膜下置管脑脊液引流治疗（B组,20例）,术区持续引流、切口愈合后拔管缝合管口治疗（C组,21例）。结果 A组切口脑脊液漏消失时间为（19.0±3.9）d,切口愈合时间为（25.0±4.6）d,8例初期治疗失败。B组切口脑脊液漏的消失时间为（3.0±1.0）d,切口愈合时间为（16.0±2.6）d,6例初期治疗失败。C组切口愈合时间为（13.0±1.0）d,均初期治疗成功。C组切口无脑脊液漏,与A、B组两组相比差异有统计学意义（P〈0.05）,切口愈合时间短于A、B组两组（P〈0.05）,初期治疗成功率高于A、B组两组（P〈0.05）。结论采用术区持续引流、切口愈合后拔管缝合管口方法治疗脊柱爆裂性骨折术后脑脊液漏疗效满意,效果优于常规方法。Objective To evaluate the clinical outcome of continuous wound drainage, removing tubes and stitching wound after incision healed for cerebrospinal fluid（CSF） leakage following spinal burst fracture operation. Methods From June 2004 to June 2010, CSF leakage occurred in 61 cases following spinal burst fracture surgery. Patients in group A （n=20） were treated by adjusting position and compression dressing wound,patients in group B （n=20） underwent lumbar pereutaneous subaraehnoid CSF drainage,and patients in group C （n=21） underwent continuous wound drainage, removing tubes and stitching wound after incision healed. Results The CSF leakage of skin incision in group A ceased at （19.0±3.9）d,the skin incision healed at （25.0±4.6）d, 8 cases didn＇t respond in the primary state of intervention. The CSF leakage of skin incision in group B ceased at （3.0±1.0）d, the skin incision healed at （16.0±2.6）d, 6 cases didn＇t respond in the primary state of intervention. In group C, no CSF leakage of skin incision happened and all skin incision got I stage heal at （13.0±1.0）d, which showed significant difference between group A and C, group B and C with regard to the CSF leakage of skin incision cease, skin incision healing time and the success ration at the primary of intervention （P 〈0.05）. Conclusion Continuous wound drainage, removing tubes and stitching wound after incision heals for CSF leakage following spinal burst fracture operation is more effective and rehable than conventional interventions.

关 键 词：脊柱骨折 爆裂性 脑脊液漏 并发症 统计学 

分 类 号：R651.1[医药卫生—外科学]