鞍区肿瘤经蝶手术并发脑脊液漏的治疗

目的探讨鞍区肿瘤经蝶切除术发生脑脊液漏的治疗及疗效。方法2009年9月至2012年8月收治的86例鞍区肿瘤均经蝶手术切除,其中发生脑脊液漏16例;所有脑脊液漏患者均行鞍底修补重建治疗。现将其临床资料进行回顾性分析。结果一期手术修补12例,二次手术修补4例。全部病例修补成功。术后随访3月-2年均无脑脊液漏复发。结论鞍区肿瘤经蝶切除术中和术后发生的脑脊液漏可利用自身肌肉组织、筋膜、脂肪及止血材料多层复合修补重建,辅以围术期综合治疗可取得较好的效果。

Treatment of cerebrospinal fluid leaks related to transphenoidal surgery for the sellar region tumors

Objective To explore the treatment of the cerebrospinal fluid leaks related to the transsphenoidal surgery for the sellar region tumors. Methods The clinical data of 16 patients with cerebrospinal fluid leaks occurring during or after the transphenoidal surgery for the sellar region tumors from September, 2009 to August, 2012 were analyzed retrospectively. All the patients with cerebrospinal fluid leaks were treated by repair and reconstruction of the sellar bases. Results All the patients with cerebrospinal fluid were cured. Following-up from 3 to 24 months showed that the cerebrospinal fluid leaks did not recurred in all the patients. Conclusions The cerebrospinal leaks related to the transphenoid surgery for the sellar region tumors may be cured by the muhilayer and composite repair and reconstruction of the sellar bases. The materials of the repair and reconstruction incude the autogenous muscle tissues, fasciae, and fat tissues and haemostatic material.