退变性腰椎疾病后路减压术后脑脊液漏的相关因素分析及处理  

Analysis and treatment of related factors of cerebrospinal fluid leakage after posterior decompression for degenerative lumbar diseases

作　　者：孟宁波 易志坚 MENG Ning-bo, YI Zhi-jian.(Second Ward of Orthopedics Department, The 148th Hospital of Chinese People＇ s Liberation Army 255300, China)

机构地区：[1]中国人民解放军第一四八医院骨科二区,255300

出　　处：《中国实用医药》2018年第29期17-18,共2页China Practical Medicine

摘　　要：目的分析退变性腰椎疾病后路减压术后脑脊液漏的相关因素及处理方法。方法 260例退变性腰椎疾病后路减压术患者作为研究对象,根据有无脑脊液漏情况分成脑脊液漏组(10例)和无脑脊液漏组(250例)。分析发生脑脊液漏现象的相关因素,并总结处理方法。结果 260例患者中10例出现脑脊液漏,发生率为3.85%。两组患者手术类型、减压节段数、融合方式比较差异具有统计学意义(P<0.05)。脑脊液漏组患者与无脑脊液漏组患者的性别、年龄、疾病类型比较差异无统计学意义(P>0.05)。翻修手术、减压节段数≥4节、后外侧融合术(PLF)是患者出现脑脊液漏的主要影响因素。结论针对退变性腰椎疾病后路减压术后脑脊液漏现象,应注意术中操作,术后卧床休息,延长术后引流时间,以保证手术效果。Objective To analyze the related factors and treatment methods of cerebrospinal fluid leakage after posterior decompression for degenerative lumbar disease. Methods A total of 260 degenerative lumbar disease patients with posterior decompression were selected as research objects, they were divided into cerebrospinal fluid leakage group for 10 cases and non cerebrospinal fluid leakage group for 250 cases according to whether there was cerebrospinal fluid leakage. The related factors of cerebrospinal fluid leakage were analyzed and the treatment methods were summarized. Results Cerebrospinal fluid leakage occurred in 10 cases of the 260 patients, and the incidence rate was 3.85%. The differences were statistically significant in the operative type, the number of decompression segment and fusion mode between the two groups（P〈0.05）. There were no significant differences in the gender, age and disease type between cerebrospinal fluid leakage group and non cerebrospinal fluid leakage group（P〉0.05）. The main influencing factors of cerebrospinal fluid leakage were revision surgery, the number of decompression segments was greater than or equal to 4 nodes and posterolateral fusion（PLF）. Conclusion In view of the cerebrospinal fluid leakage after posterior decompression for degenerative lumbar diseases, we should pay attention to intraoperative operation, rest in bed after surgery and prolong the drainage time to ensure the surgery effect.

关 键 词：退变性腰椎疾病 后路减压术 脑脊液漏 相关因素 

分 类 号：R687.3[医药卫生—骨科学]