经眉弓眶上锁孔入路治疗脑脊液鼻漏的探讨.doc

《经眉弓眶上锁孔入路治疗脑脊液鼻漏的探讨.doc》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、经眉弓眶上锁孔入路治疗脑脊液鼻漏的探讨［摘要］目的探讨经眉弓眶上锁孔入路治疗脑脊液鼻漏的病例选择、手术方法及临床价值。方法回顾性分析2012年4月〜2015年3月首都医科大学附属北京天坛医院收治的15例漏口位于额窦后壁的脑脊液鼻漏患者的临床资料，15例患者均行手术修补痿口，其中5例经眉弓眶上锁孔入路，10例经冠状切口经额下入路。观察比较两种不同入路患者的治疗效果、手术时间、术中出血量及术后住院时间。结果本组15例患者均经1次手术修补成功，1例眉弓入路和3例冠切入路患者术后出现额部麻木，患者随访9〜48个月，平均(26.4±14.0)个月，均未复发。经眉弓入路患

2、者的平均手术时间［(3.5±0.4)h］及术中出血量［(72.0±19.2)mL］均少于经冠切入路患者［(5.8±1.7)h、(301.0土34.5)mL］,差异均有高度统计学意义(P二0.002、0.000)0经眉弓入路患者的术后住院时间为5〜8d(中位数为6d),经冠切入路患者的术后住院时间为7〜12d(中位数为8d)o结论经眉弓眶上锁孔入路具有损伤小、恢复快、住院时间短等优点，对于治疗漏口位于额窦后壁的患者具有优势。［关键词］脑脊液鼻漏；眉弓；眶上锁孔入路［中图分类号］R651.1［文献标识码］A［文章编号］1673-7210(2016)03(b)-00

3、68-05［Abstract］ObjectiveToinvestigatethepropercaseselection,microsurgerytechniqueandclinicalvalueoftrans-supraorbitalkeyholeapproachforrepairingcerebrospinalfluidrhinorrhea.MethodsClinicaldataof15patientswithcerebrospinalfluidrhinorrhearesultingfromfistulasontheposteriorwalloffronta

4、lsinusinBeijingTiantanHospitai,CapitaiMedicalUniversityfromApril2012toMarch2015wereanalyzedretrospectively.Supraorbitalkeyholeapproachwasperformedon5patients,andcoronalsubfrontalapproachwasperformedon10patients・Thetreatmentresults,operationtime,operationbloodlossandthepostoperativeh

5、ospitalstaytimeofthepatientswerecomparedstatisticallybetwenthetwodifferentapproaches.ResultsAftertheoperation,allpatientsrecoveredwellandtheywerefreeoftheCSFrhinorrhea・Onepatientthatreceivedthesupraorbitalkeyholeapproachand3patientsthatreceivedthecoronalsubfrontalapproachgotpostoper

6、ativeforeheadnumbness.NopatientsgotCSFrhinorrhearecurrenceafterafollow-upof9~48months,andthemeantimewas(26.4+14.0)months.Duringtheoperation,operationtimeofpatientsthatreceivedthesupraorbitalkeyholeapproach[(3.5+0.4)h]waslessthanpatientswhoreceivedthecoronalsubfrontalappro且ch[(5.8±1.

7、7)h],bloodlossofpatientsundergonethesupraorbitalkeyholeapproach[(72.0±19・2)mL]waslessthanpatientsreceivedcoronalsubfronLalapproach[(301.0±34.5)mL],thedifferenceswerestatisticallysignificant(P二0.002,0.000)・Thepostoperativehospitalstaytimeofpatientsthatreceivedthesupraorbitalkeyholeap

8、proachwas5~8d(media