腰大池置管持续引流治疗脊柱术后脑脊液漏的疗效分析

Outcome of continuous lumbar subarachnoid drainage for postoperative cerebrospinal fluid leakage

中文关键词:  脑脊液漏  脊柱手术  腰大池置管持续引流  疗效

英文关键词:Cerebrospinal fluid leakage  Spine surgery  Continuous lumbar subarachnoid drainage  Outcome

中文摘要:

  【摘要】 目的：探讨腰大池置管持续引流治疗脊柱术后脑脊液漏的疗效。方法：2003年3月~2010年7月在我科行脊柱手术的患者共982例，术后出现脑脊液漏45例，其中26例行腰大池置管持续引流。23例为单纯脑脊液漏，采用腰大池置管持续引流；2例脑脊液漏合并颅内感染，行腰大池置管持续引流加鞘内注射抗生素；1例脑脊液漏合并颅内感染及伤口深部感染，行腰大池置管持续引流加鞘内注射抗生素，同时行伤口深部病灶清除冲洗引流。结果：26例患者均痊愈出院，腰大池置管时间平均为7.2d。无一例出现脑脊液漏复发、颅内感染和伤口感染等并发症。23例单纯脑脊液漏患者中，22例在行腰大池引流2d后脑脊液漏停止，1例在引流5d后脑脊液漏停止，腰大池置管时间平均为6.7d；2例脑脊液漏合并颅内感染患者，均在引流2d后脑脊液漏停止，腰大池置管时间均为9d；1例脑脊液漏合并颅内感染及伤口深部感染患者，经腰大池置管持续引流、鞘内注射抗生素及伤口深部病灶清除冲洗引流综合治疗14d后痊愈。结论：腰大池置管持续引流治疗脊柱术后脑脊液漏安全、有效。

英文摘要:

  【Abstract】 Objective：To evaluate the outcome of continuous lumbar subarachnoid drainage（CLSD） for postoperative cerebrospinal fluid leakage（CSFL）.Method：Of 982 cases undergoing spine surgery from March 2003 to July 2010，45 cases suffered from postoperative CSFL，of these，CLSD was performed in 26 cases，while 23 cases suffering from simple CSFL underwent CLSD，2 cases suffering from CSFL complicated with intracranial infection underwent CLSD plus intrathecal administration of antibiotics，1 case suffering from CSFL complicated with intracranial infection and deep wound infection underwent CLSD plus intrathecal，administration of antibiotics and debridement.Result：26 patients healed completely with the average drainage time of 7.2 days.No recurrence of CSFL，intracranial infection and wound infection were noted.Of 23 cases with simple CSFL，22 cases had CSFL ceased 2 days after CSLD，and 1 case ceased 5 days after CSLD，the average drainage time was 6.7 days.2 cases with CSFL and intracranial infections had CSFL ceased 2 days after CSLD，and the drainage time was 9 days.1 case with CSFL and intracranial as well as deep wound infection healed completely 14 days after CLSD and intrathecal administration of antibiotics.Conclusion：CLSD remains a reliable and effective treatment for postoperative CSFL.