保留创腔引流管治疗腰椎术后脑脊液漏探讨  

Outcomes of continuous wound cavity drainage in the treatment of cerebrospinal fluid leakage complicated in posterior lumbar spine surgery

作　　者：潘峰[1] 李章华[1] 陶凤华[1] 郭卫春[1] 任岳[1] 陶海鹰[1] 孙虹[1] 彭昊[1] 

机构地区：[1]武汉大学人民医院脊柱外科/骨一科,湖北武汉430060

出　　处：《生物骨科材料与临床研究》2012年第5期57-59,共3页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的评价保留创腔引流管治疗腰椎后路手术后脑脊液漏的疗效。方法 2007年7月~2011年7月我科共行腰椎后路手术580例,术后出现脑脊液漏27例,其中男17例,女10例,年龄42~67岁,平均58.5岁。均行术后保留创腔引流管治疗,切口愈合前应用抗生素预防感染并给予相应对症、支持治疗。观察脑脊液漏消失及切口愈合时间,并记录相关并发症发生情况。结果脑脊液漏的消失时间为6~11天,平均8.1天;切口均一期愈合,愈合时间13~20天,平均15.6天;无切口感染、化脓性脑脊膜炎等并发症发生。结论保留创腔引流管治疗腰椎后路手术后脑脊液漏有效且安全。Objective To retrospectively explore the clinical outcomes of continuous wound cavity drainage in the treatment of cerebrospinal fluid﹙CSF﹚leakage complicated in posterior lumbar spine surgery.Methods Of 580 cases undergoing posterior lumbar spine surgery from July 2007 to July 2011,27 cases developed postoperative CSF leakage,including 17 males and 10 females aged from 42 to 67 year-old with a mean of 58.5 year-old.All cases received continuous wound cavity CSF drainage.Antibiotics were administered until skin incision healed.Supportive procedures were applied when necessary.The period of CSF leakage cease and skin incision healing were documented,and postoperative complications were reviewed during follow-up.Results Follow-up lasted for 8 to 40 months﹙mean 19 months﹚.CSF leakage ceased at 6 to 11 days﹙mean 8.1 days﹚postoperatively.All skin incisions acquired primary healing at 13 to 20 days﹙mean 15.6 days﹚postoperatively.Ten cases suffered from symptoms of intracranial hypotension to different degree during drainage.Neither skin incision infection nor suppurative cerebrospinal meningitis was observed.Conclusion Continuous wound cavity drainage is effective and reliable in the treatment of cerebrospinal fluid leakage complicated in posterior lumbar spine surgery.

关 键 词：腰椎后路手术 脑脊液漏 保留创腔引流管 

分 类 号：R687.3[医药卫生—骨科学]