经皮蛛网膜下置管引流对脊柱骨折合并硬脊膜损伤术后患者脑脊液漏的影响研究

目的观察经皮蛛网膜下置管引流对脊柱骨折合并硬脊膜损伤术后患者脑脊液漏的影响。方法选取2014年6月~2017年6月我院收治的脊柱骨折合并硬脊膜损伤术后出现脑脊液漏的患者74例为研究对象,按照随机数字表法分为常规组与观察组各37例,常规组采用体位调节伤口加压包扎治疗,观察组采用经皮蛛网膜下置管引流治疗。比较两组治疗后脑脊液漏消失时间、切口愈合时间、初次治疗成功率及并发症发生率。结果观察组脑脊液漏消失时间、切口愈合时间显著短于常规组,差异有统计学意义(P0.05);观察组初次治疗成功率为97.30%,显著高于常规组78.38%,差异有统计学意义(P0.05);观察组并发症发生率为0,显著低于常规组16.22%,差异有统计学意义(P0.05)。结论与常规治疗相比,经皮蛛网膜下置管引流治疗脊柱骨折合并硬脊膜损伤术后脑脊液漏效果良好,初次治疗成功率高,并发症少。

Study on the effect of transdermal subarachnoid catheterization and drainage on cerebrospinal fluid leakage in the patients after the surgery of spinal fracture complicated with dural injury

Objective To investigate the effects of transdermal subarachnoid catheterization and drainage on cerebrospinal fluid leakage in the patients after the surgery of spinal fractures complicated with dural injury. Methods A total of 74 patients with cerebrospinal fluid leakage after the surgery of spinal fractures complicated with dural injury who were admitted to our hospital from June 2014 to June 2017 were selected as the study subjects. According to the random number table, the patients were divided into routine group and observation group, with 37 cases in each group.The routine group was given position adjustment and wound pressure bandage treatment, and the observation group was treated with percutaneous subarachnoid catheterization and drainage. The disappearance time of cerebrospinal fluid leakage, incision healing time, initial treatment success rate and complication rate were compared between the two groups. Results The disappearance time of cerebrospinal fluid leakage and incision healing time in the observation group were significantly shorter than those in the routine group, and the differences were statistically significant (P<0.05); the initial successful treatment rate in the observation group was 97.30%, significantly higher than that in the routine group (78.38%), and the difference was statistically significant(P<0.05); the incidence of complications in observation group was 0, which was significantly lower than that in the routine group(16.22%), and the difference was statistically significant(P<0.05). Conclusion Compared with the routine treatment, percutaneous subarachnoid catheterization and drainage in the treatment of cerebrospinal fluid leakage after the surgery of spinal fractures complicated with dural injury has a favorable effect, and the success rate of initial treatment is high, with fewer complications.