颅脑创伤手术同期行脑脊液鼻漏修补术临床分析  

Clinical analysis on simultaneous craniocerebral trauma operation and cerebrospinal fluid rhinorrhea repair

作　　者：林发牧[1] 许小兵[1] 彭永东[1] 陈达良[1] 

机构地区：[1]顺德第一人民医院神经外科,广东佛山528313

出　　处：《现代医药卫生》2015年第B06期1-2,5,共3页Journal of Modern Medicine & Health

摘　　要：目的探讨颅内血肿合并脑脊液鼻漏急性期术中探查、修补手术指征。方法选取2004年10月至2010年12月收治的颅内血肿合并脑脊液鼻漏患者185例,根据颅底骨折位置将其分为颅前窝、颅中窝、颅后窝3种骨折类型,并根据不同类型总结其手术入路。结果 185例患者治愈169例,死亡16例。10例患者术后仍有轻微脑脊液鼻漏,经保守治疗后脑脊液鼻漏停止。术后获随访82例,有3例脑脊液鼻漏复发,其中2例经保守治愈,1例再经蝶手术修补后治愈。结论颅内血肿同时合并颅底骨折脑脊液漏患者,手术时应注意同时行颅底探查、重建及脑脊液漏修补,可有效减少再次手术的概率。Objective To explore the operation indications of intraoperative exploration and repair in the acute stage of intracranial hematoma complicating cerebrospinal fluid rhinorrhea. Methods 185 patients with intracranial hematoma complicating cerebrospinal fluid rhinorrhea in our hospital from October 2004 to December 2010 were selected and divided into 3 types according to the basieranial fracture position. The operative approaches were summarized according to different types. Results Among 185 cases, 169 cases were cured and 6 cases died. Mild cerebrospinal fluid rhinorrhea after operation still existed in 10 eases and were stopped by the conservation treatment. 82 cases were followed up, cerebrospinal fluid rhinorrhea reoccurred in 3 cases, 2 eases were cured by the conservation treatment and 1 case was cured by trans-sphenoid operation. Conclusion For the patients with intracranial hematoma complicating basieranial fracture and eerebrospinal fluid leak, the operation should pay attention to simultaneously perform the basieranial exploration, reconstruction and cerebrospinal fluid repair,which could reduce the chance of re-operation.

关 键 词：创伤和损伤 颅骨骨折 颅脑损伤 血肿 脑脊液鼻漏/外科学 

分 类 号：R651.1[医药卫生—外科学]