创伤性脑脊液鼻漏的临床研究

目的探讨颅脑损伤并脑脊液鼻漏的诊疗方案、分析影响漏口愈合的因素及手术干预治疗的时机。方法回顾性分析我院2014年6月-2018年6月共90例颅脑损伤并脑脊液鼻漏的临床病例资料,通过单因素分析(x2)显示颅内压力、颅底多发骨折、脑(膜)组织膨出影响脑脊液鼻漏漏口的愈合(P<0.05),Logistic回归模型显示颅内压力、颅底多发骨折、脑(膜)组织膨出是影响创伤性脑脊液鼻漏漏口愈合的危险因素,分析手术干预治疗的时机。结果颅内压力、颅底多发骨折、脑(膜)组织膨出影响脑脊液鼻漏漏口的愈合,与脑脊液鼻漏的愈合有明显关系(P<0.05)。结论多发颅底骨折、合并有颅内压增高及脑组织膨出的脑脊液病人早期行手术干预,促进漏口的愈合以减少颅内感染的发生。

A clinical study of traumatic cerebrospinal fluid rhinorrhea

Objective To investigate the diagnosis and treatment regimens for traumatic brain injury with cerebrospinal fluid rhinorrhea, influencing factors for the healing of leak port, and the timing of surgical intervention. Methods A retrospective analysis was performed for the clinical data of 90 patients with traumatic brain injury and cerebrospinal fluid rhinorrhea who were treated in our hospital from June 2014 to June 2018. A univariate analysis (χ²) was used to analyze intracranial pressure, multiple fractures of the skull base, and encephalocele affected the healing of the leak port of cerebrospinal fluid rhinorrhea, and the logistic regression model was used to analyze intracranial pressure, multiple fractures of the skull base, and encephalocele were risk factors for poor healing of the leak port. The timing of surgical intervention was also analyzed. Results Intracranial pressure, multiple fractures of the skull base, and encephalocele affected the healing of the leak port of cerebrospinal fluid rhinorrhea and were significantly associated with the healing of cerebrospinal fluid rhinorrhea (P<0.05). Conclusions Surgical intervention should be performed for cerebrospinal fluid rhinorrhea patients with multiple fractures of the skull base, increased intracranial pressure, and encephalocele as early as possible, in order to promote the healing of the leak port and reduce the incidence rate of intracranial infection.