脊柱术后脑脊液漏三种处理方法的疗效比较  

Comparison of therapeutic effect of three different treatments for cerebrospinal fluid leakage induced by spinal surgery

作　　者：储朝明[1] 陈鸣[1] 吕游[1] 秦入结[1] 刘艺[1] CHU Zhaoming;CHEN Ming;LYU You;QIN Rujie;LIU Yi(Department of Spine Surgery,the First People′s Hospital of Lianyungang,Jiangsu Province,Lianyungang 222000,China)

机构地区：[1]江苏省连云港市第一人民医院脊柱外科,江苏连云港222000

出　　处：《中国医药导报》2020年第20期140-143,共4页China Medical Herald

摘　　要：目的比较伤口加压包扎、蛛网膜下置管引流和延长切口引流3种方法处理脊柱术后脑脊液漏的效果。方法回顾性分析2008年3月~2017年3月江苏省连云港市第一人民医院脊柱外科术后脑脊液漏患者183例,按术后处理方法不同分为三组:伤口加压包扎法61例(A组),蛛网膜下置管引流方法25例(B组),延长切口引流法97例(C组)。比较三组脑脊液漏时间、切口愈合时间、换药次数、初次治疗成功率和并发症发生率,以及术后发热、头痛、炎症指标增高、异常切口疼痛、肌力感觉异常发生率。结果C组、B组脑脊液漏时间、切口愈合时间短于A组、换药次数少于A组,C组脑脊液漏时间、切口愈合时间短于B组,换药次数少于B组。C组初次治疗成功率高于A、B组,C、B组并发症发生率低于A组,差异有统计学意义(P<0.05);但A、B组初次治疗成功率以及C、B组并发症发生率比较,差异无统计学意义(P>0.05)。B、C组术后发热、炎症指标增高、头痛、切口异常疼痛、肌力感觉减退、总发生均少于A组,差异均有统计学意义(均P<0.05);B组、C组比较,差异无统计学意义(P>0.05)。结论延长切口引流是处理脊柱术后脑脊液漏简单、有效的方法。Objective To compare the effects of three methods of wound compression bandaging,subarachnoid tube drainage and prolonged incision drainage on cerebrospinal fluid leakage after spinal surgery.Methods From March2008 to March 2017,183 patients from the Department of Spine Surgery,the First People′s Hospital of Lianyungang,Jiangsu Province,with cerebrospinal fluid leakage after spinal surgery were retrospectively analyzed.They were divided into three groups:wound compression bandaging method with 61 cases(group A),subarachnoid tube drainage methods with 25 cases(group B),prolonged incision drainage method with 97 cases(group C)according to the postoperative treatment method.The cerebrospinal fluid leakage time,incision healing time,dressing change times,success rate of initial treatment and incidence of complications were compared among the three groups,as well as the incidence of postoperative fever,headache,increased inflammatory indicators,abnormal incision pain and muscle dyspepsia.Results The cerebrospinal fluid leakage time,incision healing time in group C,group B was shorter than those in the group A,the frequency of dressing change was less than that in group A,the cerebrospinal fluid leakage time,incision healing time in group C were shorter than that in the group B,the dressing change times was less than that in group B.The success rate of initial treatment in group C was higher than that in group A and B,and the incidence of complications in group C and group B was lower than that in group A,with statistically significant differences(P<0.05).However,there was no statistically significant difference in the success rate of initial treatment between group A and group B or the incidence of complications between group C and group B(P>0.05).Postoperative fever,increased inflammatory indicators,headache,abnormal incision pain,muscle strength hypoesthesia,and total occurrence in group B and group C were all less than those in group A,with statistically significant differences(P<0.05).There was no significant di

关 键 词：脊柱手术 脑脊髓液 硬脊膜损伤 引流 

分 类 号：R651.15[医药卫生—外科学]