| 颈椎术后脑脊液漏的预防及处理 |
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投稿时间：2009-09-08
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| 作者 | Author | 单位 | Address | E-Mail |
| 徐荣明 |
XU Rong-ming |
宁波市第六医院脊柱外科,宁波 浙江 315040 |
Department of Orthopaedics,Ningbo the 6th Hospital of Zhejiang Province,Ningbo 315040,Zhejiang,China |
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| 朱彦昭 |
ZHU Yan-zhao |
宁波市第六医院脊柱外科,宁波 浙江 315040 |
Department of Orthopaedics,Ningbo the 6th Hospital of Zhejiang Province,Ningbo 315040,Zhejiang,China |
allyssess@163.com |
| 马维虎 |
MA Wei-hu |
宁波市第六医院脊柱外科,宁波 浙江 315040 |
Department of Orthopaedics,Ningbo the 6th Hospital of Zhejiang Province,Ningbo 315040,Zhejiang,China |
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| 吴建民 |
WU Jian-min |
浙江中医药大学附属第二医院 |
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| 期刊信息：《中国骨伤》2010年，第23卷，第1期，第20-22页 |
| DOI：10.3969/j.issn.1003-0034.2010.01.007 |
| 基金项目: |
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中文摘要:
目的：探讨颈椎手术中脑脊液漏的外科处理措施，并观察其疗效。
方法：系统回顾2004年2月至2008年2月607例颈椎手术，并对其中发生脑脊液漏的6例进行分析，其中男4例，女2例；年龄47～75岁，平均60岁；病程6个月～5年。6例中，术后1～3 d发现4例，术后5 d发现2例。2例采用切口旁引流，2例采用蛛网膜下腔引流，2例采用加压包扎。观察并记录处理结果。
结果：脑脊液漏于1～3 d停止，蛛网膜下腔引流持续10～14 d,平均引流量320 ml,3例有头痛、恶心、呕吐，1例出现嗜睡和低血钠症，经对症处理及静脉输液症状消失。所有病例均获随访，平均时间30个月，未发现脑脊液囊肿，感染等并发症。对神经肌肉功能的恢复没有明显影响。
结论：颈椎术后脑脊液漏及时正确处理效果较好，脑脊液渗出较多时，可采用切口旁引流和蛛网膜下腔引流。 |
| 【关键词】颈椎 手术后并发症 脑脊液流出，硬膜下 |
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| The prevention and treatment of cerebrospinal fluid leakage following cervical spine surgery |
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ABSTRACT
Objective: To investigate curative effect of the prevention and treatment in cerebrospinal fluid leakage(CFL) after cervical surgery.
Methods: Medical records of 607 patients who underwent cervical surgery at our hospital from Feb.2004 to Feb.2008 were retrospectively reviewed. Six patients complicated by CFL after surgery were enrolled,of which 4 males and 2 females,age for 47-75 years with an average of 60 years. Course of disease was from 6 months to 5 years. 4 cases occurred at 1-3 days after operation and 2 cases at 5 days. 2 cases were treated through latero-incision drainage,2 cases continuous subarachnoid drainage,and 2 cases pressure dressing. Clinical outcomes of surgical management were recorded.
Results: CFL of all the cases was stopped within 1-3 days after operation,and subarachnoid drainage lasted 10-14 days with an average volume of 320 ml. Three cases had headache,nausea and vomiting; 1 case suffered from somnolence and hyponatremia,and symptoms subsided after treatment. All patients were followed up with an average of 30 months. No cerebrospinal fluid cyst or wound infection were found. There was no significant effects on neuromuscular function recovery.
Conclusion: Timely and correct surgical intervention and postoperative management have good results for CFL. If it is severe,latero-incision drainage and continuous subarachnoid drainage should be adopted. |
| KEY WORDS Cervical vertebrae Postoperative complications Cerebrospinal fluid effusion,subdural |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 徐荣明,朱彦昭,马维虎,吴建民.颈椎术后脑脊液漏的预防及处理[J].中国骨伤,2010,23(1):20~22 |
| 英文格式: | XU Rong-ming,ZHU Yan-zhao,MA Wei-hu,WU Jian-min.The prevention and treatment of cerebrospinal fluid leakage following cervical spine surgery[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(1):20~22 |
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