小儿颅脑手术后切口脑脊液漏原因分析及处理  

Analysis and Treatment of Cerebrospinal Fluid Leakage in Incision of Brain Surgery in Children

作　　者：杜鹏[1] 木依提[1] 栾新平[1] 苑杨[1] 

机构地区：[1]新疆医科大学第二附属医院神经外科,乌鲁木齐830063

出　　处：《新疆医学》2016年第3期271-273,共3页Xinjiang Medical Journal

基　　金：阿勒泰地区基金;项目编号:201510

摘　　要：目的通过汇总分析我院近10年小儿颅脑术后出现脑脊液漏原因及处理措施,总结脑脊液漏原因和好的处理方法。方法收集我院2005年1月-2015年7月收住并行颅脑手术小儿患者101例,其中术后脑脊液11例,占11%。并对脑脊液漏患儿手术部位、病变、营养状况、配合程度、术后脑积水缓解情况、术后颅压情况等因素分析。结果 11例中,小脑肿瘤术后为2例,松果体区术后3例,脑室腹腔分流术后为4例,颅咽管瘤术后2例;发生时间：术后4-7 d 2例,术后8-10 d8例,术后10-14 d 1例;出现脑脊液漏原因有：术后颅压存在持续增高或波动过大、切口反复受压、水电解紊乱、长期高热,营养不良。通过对症加强抗感染、加强营养、加强缝合、留置腰大池引流、脑室腹腔分流多数得到有效治疗,1例反复颅内感染,患儿父母放弃治疗,治疗无效,死亡。结论对于小儿颅脑手术前后注意患儿营养,术后加强抗感染、加强营养、加强缝合、留置腰大池引流、脑室腹腔分流可减少脑脊液漏并使脑脊液漏得到很好处理。Objective Through the summary and analysis in our hospital in recent ten years about cerebrospinal fluid leakage after infantile craniocerebral surgery, reasons and good treatments were summarized. Methods 101 patients who were proceeded pediatric cerebral surgery in our hospital from January 2005 to July 2005 were analysed. Among them, there were 11 cases who got postoperative cerebrospinal fluid, accounting for 11%. In 11 patients, surgical site, pathological changes, nutritional status, coordination degree,postoperative hydrocephalus, postoperative cranial pressure were analyzed. Results In 11 cases, there were 2 cases having cerebellar tumor resection; There were 3 cases who had pineal region tumors; There were 4 cases who got ventricle peritoneal shunt, There were 2cases having craniopharyngioma resection; The occuring time in 2 cases was 4 - 7 d after the operation, The occuring time in 8 cases were8 - 10 d after operation. And the occuring time was 10 - 14 d after surgery in 1 case. There were different reasons to induce this disease.most cases were relieved by strengthening infection treatment, supplying nutrition, strengthening the suture, using lumbar drainage of large pool and giving ventricle peritoneal shunt. Conclusion Cerebrospinal fluid leakage and cerebrospinal fluid leakage can be reduced for infantile craniocerebral surgery through strengthening nutrition before and after operation, strengthening anti-infection, strengthening the suture, using lumbar drainage of large pool and ventricle peritoneal shunt.

关 键 词：小儿颅脑手术 脑脊液漏 原因分析 处理 

分 类 号：R743.9[医药卫生—神经病学与精神病学]