腰大池引流在脑肿瘤切除术中的辅助作用46例分析

目的总结腰大池置管引流在脑肿瘤切除术中的辅助作用.方法分析46例脑肿瘤切除术中行腰大池置管脑脊液引流应用效果.麻醉成功后腰大池穿刺置外引流管,于剪开硬脑膜前放出脑脊液30～50mL,术中根据脑回缩情况可继续放出脑脊液,术后继续引流血性脑脊液,2～4 d天拔管.结果本组46例患者手术野有良好显露,明显利于肿瘤切除,肿瘤全切率为80%.术后康复良好,无一例出现因牵拉过度引起脑挫伤或出血,也无脑积水发生.结论术中行腰大池引流能快速降低颅内压,增加手术野显露,减少脑牵拉伤及术后并发症发生.

Auxiliary role of lumbar cistern drainage in brain tumor resection: report of 46 cases

Objective To summarize the auxiliary role of lumbar cistern drainage in brain tumor resection. Methods The data of 46 cases undergoing brain tumor resection combined with lumbar cistern drainage were analyzed to clarify the importance of the drainage. The drainage tube was placed into the lumbar cistern by lumbar puncture after general anesthesia, and 30~50 mL cerebrospinal fluid was drained from it before openning cerebral dura mater and then indwelled for 2~4 d continuous drainage of blood cerebrapinal fluid after operation. Results The method provided good operative exposure in the 46 cases, which was beneficial for the resection of tumors. There is no case of cerebral confusion or hemorrhage from retraction of brain. The tumors were totally removed in 80%. Follow-up for 3 months to 2 years showed no hydrocephalus in all patients. Conclusion Lumbar cistern drainage is able to decompress the intracranial pressure quickly, enhance the exposure of operative field, decrease brain retraction injuries and ultimately postoperative complications.