胸腰椎后路手术并发脑脊液漏的防治

目的探讨胸腰椎后路手术中硬脊膜损伤及术后脑脊液漏的外科处理措施,并观察其疗效。方法对胸腰椎后路手术并发脑脊液漏17例患者,采用手术修补、加强漏口缝合、置管持续引流同时合理应用抗生素、保持伤口清洁等治疗。结果 17例切口漏均于7～14 d停止,全部治愈。结论术中修补、严密缝合切口、置管持续引流同时合理应用抗生素、保持伤口清洁等治疗是防治脑脊液漏的有效方法。

Prevention and Treatment of Cerebrospinal Fluid Leakage in Posterior Thoracolumbar Spinal Surgery

Objective To investigate the surgical management of dural injury and postoperative cerebrospinal fluid（CSF） fistulas in posterior thoracolumbar spinal surgery,and to observe the clinical outcomes.Methods Among 256 patients who underwent posterior thoracolumbar spinal surgery,17 cases of CSF leakage were treated with surgical repair of duramater,reinforcement of stitching fistulas,closed continuous drainage with proper use of antibiotics,and keeping clean incision,etc.Results All patients were successfully treated for CSF leakage in 7～14 days.Conclusion The surgical management such as repairing duramater,stitching fistulas,closed continuous drainage with proper use of antibiotic,and keeping the incision clean was effective and safe for prevention and treatment of CSF leakage in posterior thoracolumbar spinal surgery.