成人创伤性脑脊液漏诊治中国专家共识(2023版)  

Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults(version 2023)

作　　者：范凡[1] 冯军峰[2] 陈鑫[1] 韩凯伟 黄贤键[4] 李春涛[1] 刘子源 钟春龙[5] 陈礼刚 陈文劲[7] 董斌[8] 段继新 方文华[10] 冯光[11] 高国一 高亮 杭春华 贺礼进 侯立军 黄齐兵[16] 江基尧[2] 江荣才[17] 蓝胜勇[18] 李立宏 刘劲芳[1] 刘志雄[1] 罗正祥[20] 迁荣军[11] 邱炳辉[21] 屈洪涛[22] 石广志[12] 舒凯[23] 孙海鹰 孙晓欧[25] 王宁[7] 王清华[26] 王玉海 魏俊吉[28] 魏祥品[29] 徐立新[30] 杨朝华[31] 杨华 杨理坤 杨小锋[33] 虞仁和[34] 张永明 赵卫平 中华医学会神经外科学分会颅脑创伤专业组 中华医学会创伤学分会神经损伤专业组 Fan Fan;Feng Junfeng;Chen Xin;Han Kaiwei;Huang Xianjian;Li Chuntao;Liu Ziyuan;Zhong Chunlong;Chen Ligang;Chen Wenjin;Dong Bin;Duan Jixin;Fang Wenhua;Feng Guang;Gao Guoyi;Gao Liang;Hang Chunhua;He Lijin;Hou Lijun;Huang Qibing;Jiang Jiyao;Jiang Rongcai;Lan Shengyong;Li Lihong;Liu Jinfang;Liu Zhixiong;Luo Zhengxiang;Qian Rongjun;Qiu Binghui;Qu Hongtao;Shi Guangzhi;Shu Kai;Sun Haiying;Sun Xiaoou;Wang Ning;Wang Qinghua;Wang Yuhai;Wei Junji;Wei Xiangpin;Xu Lixin;Yang Chaohua;Yang Hua;Yang Likun;Yang Xiaofeng;Yu Renhe;Zhang Yongming;Zhao Weiping;Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association;Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association(Xiangya Hospital,Central South University,Changsha 410008,China;Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127,China;Second Affiliated Hospital of Navy Medical University,Shanghai 200003,China;Shenzhen Second People′s Hospital,Shenzhen 518035,China;Shanghai East Hospital,School of Medicine,Tongji University,Shanghai 200120,China;Affiliated Hospital of Southwest Medical University,Luzhou 646000,China;Xuanwu Hospital,Capital Medical University,Beijing 100053,China;First Affiliated Hospital of Dalian Medical University,Dalian 116011,China;Hunan Aerospace Hospital,Changsha 410205,China;First Affiliated Hospital,Fujian Medical University,Fuzhou 350005,China;Henan Provincial People′s Hospital,Zhengzhou 450003,China;Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Shanghai Tenth People′s Hospital,Shanghai 200072,China;Nanjing Drum Tower Hospital Affiliated to Nanjing University School of Medicine,Nanjing 210008,China;Central Hospital of Yongzhou,Yongzhou 425000,China;Qilu Hospital of Shandong University,Jinan 250012,China;General Hospital of Tianjin Medical University,Tianjin 300052,China;People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China;Tangdu Hospital of Air Force Medical University,Xi′an 710038,China;Affiliated Br

机构地区：[1]中南大学湘雅医院,长沙410008 [2]上海交通大学医学院附属仁济医院,上海200127 [3]海军军医大学第二附属医院,上海200003 [4]深圳市第二人民医院,深圳518035 [5]同济大学附属东方医院,上海200120 [6]西南医科大学附属医院,泸州646000 [7]首都医科大学附属北京宣武医院,北京100053 [8]大连医科大学附属第一医院,大连116011 [9]湖南航天医院,长沙410205 [10]福建医科大学附属第一医院,福州350005 [11]河南省人民医院,郑州450003 [12]首都医科大学附属北京天坛医院,北京100070 [13]上海市第十人民医院,上海200072 [14]南京大学医学院附属南京鼓楼医院,南京210008 [15]永州市中心医院,永州425000 [16]山东大学齐鲁医院,济南250012 [17]天津医科大学总医院,天津300052 [18]广西壮族自治区人民医院,南宁530021 [19]空军军医大学唐都医院,西安710038 [20]南京脑科医院,南京210029 [21]南方医科大学南方医院,广州510515 [22]南华大学附属第一医院,衡阳421001 [23]华中科技大学同济医学院附属同济医院,武汉430030 [24]邵阳市中心医院,邵阳422000 [25]苏州大学附属第一医院,苏州215006 [26]南方医科大学珠江医院,广州510282 [27]联勤保障部队第九〇四医院,无锡214041 [28]北京协和医院,北京100032 [29]安徽省立医院,合肥230001 [30]常德市第一人民医院,常德415003 [31]四川大学华西医院,成都610041 [32]贵州医科大学附属医院,贵阳550004 [33]浙江大学医学院附属第一医院,杭州310003 [34]中南大学公共卫生学院,长沙410006 [35]安徽省第二人民医院,合肥230041 [36]内蒙古自治区人民医院,呼和浩特010017 [37]不详

出　　处：《中华创伤杂志》2023年第9期769-779,共11页Chinese Journal of Trauma

摘　　要：创伤性脑脊液漏常见于颅脑创伤患者,可引起脑膜炎、脑室炎、脑脓肿、硬膜下血肿、张力性气颅等并发症,如漏诊误诊延误治疗或治疗方式、时机不当,可能导致严重并发症并危及患者生命。部分创伤性脑脊液漏临床表现隐蔽、易漏诊。因损伤部位、机制及脑脊液漏程度不同,创伤性脑脊液漏确诊后的治疗方案个体差异大。为此,中华医学会神经外科学分会颅脑创伤专业组和中华医学会创伤学分会神经损伤专业组组织相关专家,基于循证证据和临床经验,制订《成人创伤性脑脊液漏诊治中国专家共识(2023)》,主要从创伤性脑脊液漏的诊断和定位、治疗及颅内感染防治方面提出16条推荐意见,以规范创伤性脑脊液漏的临床诊疗,改善患者预后。Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients,and it may lead to complications such as meningitis,ventriculitis,brain abscess,subdural hematoma or tension pneumocephalus.When misdiagnosed or inappropriately treated,traumatic cerebrospinal fluid leakage may result in severe complications and may be life⁃threatening.Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis.Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak,treatments for traumatic cerebrospinal fluid leakage varies greatly.Hence,the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the"Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults(version 2023)"based on existing clinical evidence and experience.The consensus consisted of 16 recommendations,covering the leakage diagnosis,localization,treatments,and intracranial infection prevention,so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

关 键 词：脑脊液漏 颅脑损伤 感染 共识 

分 类 号：R651.15[医药卫生—外科学]