脊柱外科中脑脊液漏的防治

目的：探讨脊柱外科中较常见并发症脑脊液漏的防治措施。方法：通过回顾性的方法对1995年1月－2000年5月发生的21例脊柱手术后脑脊液漏患者的临床资料进行分析总结。结果：经过术中、术后仔细的处理，21例脑脊液漏患者除1例保守治疗无效于21d再次开放切口修补硬膜外，其余20例患者全部经保守治疗后于6－36d内治愈，无1例发生脑脊髓膜炎；36例腰椎手术脑脊液漏患者随访术后3月－2年内发现形成脑脊液囊肿。结论：通过术中对硬脊膜损伤及时修补或堵塞，术后采取正确的保守治疗措施，绝大多数脑脊液漏均可治愈，极少数保守治疗无效者需开放切口，重新修补硬膜。对晚期形成的交通性或有症状的脑脊液囊肿，可 采取手术切除。

Prevention and Treatmentof Cerebrospinal Fluid Leakage in Spinal Surgery

Objective:To analyze the prevention and treatment of cerebrospinal fluid leakage in spinal surgery.Methods:A retrospective analysis was taken to the 21 cases suffered from cerebrospinal fluid leakage after spinal surgery from January 1995 to May 2000.Results:Through careful treatment peri operation,20 cases cured between 6 days and 36 days by conservative measurements,incision was applied in one case for repairing dura mater,no cerebrospinal meningitis occured;6 cases after lumbar spinal sugery had cerebrospinal fluid cysts formation after 3 months to 2 years.Conclusions:Almost all cerebrospinal fluid leakage can be cured by repairing dura mater or blocking up leakage in operation and regular conservative treatment after operation.A few cases failing to conservative treatment need reopen incision for repairing dura mater.The symptomatic and conmmunicating cerebrospinal fluid cysts can be treated by surgery.