中国组织工程研究

中国组织工程研究 ›› 2013, Vol. 17 ›› Issue (48): 8413-8418.doi: 10.3969/j.issn.2095-4344.2013.48.019

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

颈椎术后脑脊液漏治疗：不同引流方法比较

马  良，盛伟斌，邓  强   

  1. 新疆医科大学第一附属医院脊柱外科，新疆维吾尔自治区乌鲁木齐市  830054
  • 出版日期:2013-11-26 发布日期:2013-11-26
  • 通讯作者: 邓强，在读博士，副主任医师，讲师，新疆医科大学第一附属医院脊柱外科，新疆维吾尔自治区乌鲁木齐市830054
  • 作者简介:马良★，男，1988年生，新疆维吾尔自治区乌鲁木齐市人，回族，在读硕士，主要从事脊柱外科研究。 413474500@qq.com
  • 基金资助:

    新疆医科大学第一附属医院科研专项基金(2010ZZGC04)*，项目名称：多基因共同转染脂肪干细胞向成骨细胞转化的体外实验研究

Comparison of various drainage methods for postoperative cerebrospinal fluid leakage in cervical vertebra

Ma Liang, Sheng Wei-bin, Deng Qiang   

  1. Department of Spinal Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi  830054, Xinjiang Uygur Autonomous Region, China
  • Online:2013-11-26 Published:2013-11-26
  • Contact: Deng Qiang, Studying for doctorate, Associate chief physician, Lecturer, Department of Spinal Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • About author:Ma Liang★, Studying for master’s degree, Department of Spinal Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China 413474500@qq.com
  • Supported by:

    the Science Research Foundation of First Affiliated Hospital of Xinjiang Medical University, No. 2010ZZGC04*

PDF

705

摘要：

背景：大量的文献报道了脊柱术后脑脊液漏的各种治疗方法，包括术中及术后的处理措施，而仅针对颈椎术后脑脊液漏采用腰椎蛛网膜下腔置管引流的治疗方法报道甚少。
目的：评价术区持续引流和腰椎蛛网膜下腔置管引流对颈椎术后脑脊液漏的治疗效果。
方法：2009年6月至2012年10月新疆医科大学第一附属医院脊柱外科行颈椎手术923例，术后出现脑脊液漏24例，脑脊液发生率为2.6%(24/923)，均为术中无法修补的硬膜裂伤及未发现的硬膜破裂而发生脑脊液漏。其中12例患者采用腰椎蛛网膜下腔置管治疗(置管组)，12例患者术区持续引流治疗(引流组)。
结果与结论：与引流组比较，置管组脑脊液漏停止时间明显缩短(P < 0.05)。置管组出现1例脑脊液感染，引流组出现2例脑脊液囊肿，1例脑脊液感染，均给予对症治疗后治愈。24例均获得随访，随访时间9-12个月，均未出现脑脊液漏、脑脊液感染、脑脊液囊肿等并发症。结果可见腰椎蛛网膜下腔置管引流在治疗颈椎术后脑脊液漏方面有较好疗效。

关键词: 骨关节植入物, 骨与关节临床实践, 脑脊液漏, 颈椎术后, 蛛网膜下腔, 置管, 治疗效果, 并发症, 脑脊液囊肿, 脑脊液感染, 持续引流, 硬膜, 其他基金

Abstract:

BACKGROUND: Numerous studies have demonstrated various therapeutic methods for cerebrospinal fluid leakage after spinal column surgery, including intraoperative and postoperative measures. Few studies addressed the therapeutic methods of cerebrospinal fluid leakage after cervical vertebra surgery using lumbar subarachnoid catheter drainage.
OBJECTIVE: To evaluate the therapeutic efficacy of sustainable drainage and lumbar subarachnoid catheter drainage for cervical postoperative cerebrospinal fluid leakage.
METHODS: 923 patients underwent cervical spine surgery in the Department of Spinal Surgery, the First Affiliated Hospital of Xinjiang Medical University, China from June 2009 to October 2012. There were 24 cases of postoperative cerebrospinal fluid leakage with an incidence of cerebrospinal fluid leakage of 2.6% (24/923). The dural laceration that could not be repaired or be found induced cerebrospinal fluid leakage. Of them, 12 cases received lumbar subarachnoid catheter drainage (catheter group), and 12 cases received sustainable drainage (drainage group).
RESULTS AND CONCLUSION: Compared with the drainage group, the duration of cerebrospinal fluid leakage was significantly shorter in the catheter group (P < 0.05). In the catheter group, one case affected cerebrospinal fluid infection. In the drainage group, two cases experienced cerebrospinal fluid cyst and one case suffered from cerebrospinal fluid infection. They were cured by symptomatic treatment. A total of 24 cases were followed up for 9-12 months. None of them affected cerebrospinal fluid leakage, cerebrospinal fluid infection or cerebrospinal fluid cyst. Results demonstrated that lumbar subarachnoid catheter drainage in the treatment of cervical postoperative cerebrospinal fluid leakage has a good effect.

Key words: cervical vertebrae, wounds and injuries, subarachnoid space, drainage

中图分类号: