脊柱术后脑脊液漏的处理

目的探讨脊柱术后脑脊液漏(leakage of cerebrospinal fluid)的处理及预防。方法自1998年5月~2006年7月本科共收治57例脑脊液漏患者,其中5例发生在颈椎前路手术,6例发生于胸腰椎前路手术,46例发生于腰椎后路手术。患者年龄27~63岁,平均45岁,其中男35例,女22例。结果脑脊液漏持续时间2~21d,平均3.5d。其中56例患者均经保守治疗(采用体位治疗、拔除引流、加压包扎)痊愈,1例患者在拔除引流管后21d脑脊液漏仍未停止,采用硬脊膜修复术后痊愈,本组病例中无一例出现感染。结论体位治疗、拔除引流、加压包扎是治疗脊柱术后脑脊液漏的有效方法。

The treatment of leakage of cerebrospinal fluid after spinal operation

Objective To approach the treatment and prevention of the leakage of cerebrospinal fluid after spinal operation.Methods There were 57 patients with leakage of cerebrospinal fluid during 1998 to 2006 after spinal operation,including 5 patients after cervical vertebra anterior approach operation,6 patients after thoracic vertebrae and lumbar operation,the other 46 patients were after lumbar posterior approach operation.The age was 27 to 63 years old,average 45 years old.There were 35 males and 22 females.Results The persistence time of leakage of cerebrospinal fluid was 2 to 21 days,average 3.5 days.Fifty six patients recovery after expectant treatment(adopting body position treatment,pulling out the drainage and pressure dressing).The leakage of cerebrospinal fluid did not stopped 21 days after pulling out the drainage in 1 patient,and recoveried after repairing of spinal meninges.There was no one infection in this group.Conclusion Body position treatment,pulling out the drainage and pressure dressing is a kind of effective method to treat the leakage of cerebrospinal fluid after spinal operation.