脊柱手术后并发脑脊液漏的临床观察及治疗

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1、脊柱手术后并发脑脊液漏的临床观察及治疗周凡（湖北省大悟县人民医院骨科湖北大悟432800）【摘要】目的：总结脊柱手术患者术后并发脑脊液漏的临床观察方法，探讨有效的临床治疗对策。方法：回顾性分析我院2012年6月〜2015年11月间收治的48例脊柱手术后并发脑脊液漏患者的临床资料，加强对患者的病情观察，同时根据治疗方法的不同将患者分为常规治疗组（对照组，21例）和腰部持续性蛛网膜下腔引流治疗组（观察组，27例），观察比较临床治疗效果。结果：研究结果发现观察组患者的平均脑脊液漏消失时间、引流管拔除时间及伤口愈合时间均少于对照组患者，组间差异有统计学意义（P<0.05）。两组患者出院后随

2、访3〜6个月，均未出现严重并发症，随访期内无复发病例。结论：医务人员应加强对脊柱手术后并发脑脊液漏患者的观察，以便早期进行处理，腰部持续蛛网膜下腔引流技术是治疗术后并发脑脊液漏的有效方法，可提高临床治疗效果，值得临床推广应用。【关键词】脊柱手术：脑脊液漏；持续性腰部蛛网膜下腔引流；临床疗效【中图分类号】R619【文献标识码】A【文章编号】2095-1752（2016）24-0241-02Clinicalobservationandtreatmentofcerebrospinalfluidleakageafterspinalsurgery[Abstract]ObjectiveTosumma

3、rizetheclinicalmethodsofcerebrospinalfluidleakageafterspinaloperationandtoexploretheeffectivetreatmentofpatientswithspinalsurgery.MethodsaretrospectiveanalysisofourhospitalinJune2012to2015Novemberwere48caseswithcerebrospinalfluidleakageafterspinalsurgeryclinicaldata,strengthentothepatient’sillnes

4、sobservation,atthesametime,accordingtodifferenttreatmentmethods,thepatientsweredividedintoconventionaltreatmentgroup(controlgroup,21cases)andcontinuouslumbarsubarachnoiddrainageinthetreatmentgroup(observationgroup,27cases)wereobservedtocomparetheclinicaltreatmenteffect.Resultsintheobservationgrou

5、p,thedisappearancetimeofcerebrospinalfluidleakage,thetimeofremovalofthedrainagetubeandthehealingtimewerelessthanthatofthecontrolgroup,thedifferencewasstatisticallysignificant(P<O.O5).Twogroupsofpatientswerefollowedupfor6to3monthsafterdischarge,noseriouscomplicationsoccurred.Norecurrencewasfoun

6、dduringthefollow-upperiod.Conclusionmedicalpersonnelshouldbestrengthenedwithcerebrospinalfluidleakageafterspinalsurgerywereobservedtoearlytreatment,lumbarsubarachnoidspacecontinuousdrainageofcerebrospinalfluidleakageaftersurgeryinthetreatmentofeffectivemethod,canimprovetheclinicaltreatmenteffecta

7、ndisworthyofclinicalapplication.【Keywords]Spinalsurgery;Cerebrospinalfluidleakage;Continuouslumbarsubarachnoiddrainage;Clinicalefficacy脑脊液漏是脊柱手术后患者常见的一种并发症，其发生率为2.31%〜9.37%[1],患者若得不到及吋奋效的处理可能会出现脊膜假性囊肿和颅内感染，严重者可威胁生命。因此术