颅脑术后切口脑脊液漏治疗体会  

Experience on treatment of cerebrospinal fluid leakage after craniocerebral operation

作　　者：李佳盛 廖勇仕[1] 曹果 周宇翔[1] 周敏[1] 

机构地区：[1]南华大学附属第二医院神经外科,衡阳421001

出　　处：《中华神经创伤外科电子杂志》2015年第6期14-16,共3页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

摘　　要：目的探讨开颅术后患者脑脊液切口漏的有效预防及治疗措施。方法回顾性分析自2012年1月至2015年1月南华大学附属第二医院收治的行开颅手术治疗的脑外伤、脑出血且术后出现脑脊液切口漏的患者21例,其中脑出血的7例,脑外伤的14例,发生在术后4~7 d的5例,8~11 d的12例,11~14 d的6例,采取积极处理漏口,预防漏口感染,解除颅高压因素（包括持续腰大池引流等）有效控制颅内压,保证机机体足够的能量供应。结果 2012年1月至2015年1月收治的行开颅手术脑脊液切口漏的21例患者中,经过系统有效治疗后,14例患者第2天脑脊液漏完全停止,其余的7例患者脑脊液漏均明显减少,且均于治疗后5 d内完全停止,无一例发生脑脊液感染。结论通过对漏口的规范处理、保持漏口干燥,积极控制颅内压,保证机体足够的能量供应,对颅脑术后脑脊液漏效果显著。Objective To study the treatment of leakage of cerebrospinal after craniocerebral operation. Methods Analyzed retrospectively from January 2012 to January 2015, treated by the second affiliated hospital of nanhua university do surgical operation treatment of brain injury, cerebral hemorrhage and postoperative cerebrospinal fluid leakage of incision, increase of 21 eases of patients, 7 cases of cerebral hemorrhage, 14 cases of traumatic brain injury, occurred in the 4-7 d in 5 cases, 8-11 d in 12 cases, 11-14 d in 6 cases, take active treatment leaks, to prevent leaks infection, relieve cranial pressure factors （including continuous lumbar drainage of large pool, etc.） and effective control of intracranial pressure, ensure the machine body enough energy supply. Results Between January 2012 and January 2015 lines of cerebrospinal fluid leakage of incision surgical operation in 21 cases of patients, after system effective treatment, 14 patients with 2 days of cerebrospinal fluid leakage stop completely, cerebrospinal fluid leakage of the rest of the 7 cases were significantly reduced, and are completely stop within 5 d after treatment, no case of infection of eerebrospinal fluid. Conclusion Through the process specification of leaks, keep dry and leaks, active control of intracranial pressure, guarantee the body enough energy supply, the cerebral postoperative cerebrospinal fluid leakage effect is remarkable.

关 键 词：控制颅内压 治疗 脑脊液漏 

分 类 号：R651.1[医药卫生—外科学]