49例外伤性脑脊液漏临床分析

发布时间：2018-06-09 05:40

本文选题：外伤性脑脊液漏 + 保守治疗　；参考：《广西医科大学》2015年硕士论文

【摘要】：目的：总结外伤性脑脊液漏的诊治经验,探讨有效的治疗方法。方法：回顾性分析广西医科大学第一附属医院神经外科2008年1月至2014年6月收治的49例外伤性脑脊液漏患者资料,依病情分别采取保守治疗和手术治疗,保守治疗包括常规保守治疗和腰大池持续外引流治疗,归纳病例特点,总结经验。结果：49例患者中,5例伤后早期接受手术,4例痊愈,1例死亡。.44例初期先行保守治疗,30例通过常规保守治疗在1W内痊愈,14例在1W内无明显好转,予加行腰大池置管持续外引流治疗,8例经持续引流在2W内痊愈,6例经引流2W脑脊液漏无明显减少,予行延期脑脊液漏修补术,5例一次手术修补成功,1例继发颅内感染复发,再次手术后痊愈。结论：通过正确的处理,绝大多数外伤性脑脊液漏患者经保守治疗可取得满意效果,对骨折严重、颅内血肿量大、脑脊液漏明显的患者常需早期行手术治疗,对经保守治疗3W效果不佳的患者应行延期脑脊液漏修补术,以免病情迁延、恶化。
[Abstract]:Objective: to summarize the experience of diagnosis and treatment of traumatic cerebrospinal fluid leakage (TCSF). Methods: the data of 49 patients with traumatic cerebrospinal fluid leakage admitted from January 2008 to June 2014 in the Neurosurgery Department of the first affiliated Hospital of Guangxi Medical University were retrospectively analyzed. Conservative treatment includes routine conservative treatment and continuous external drainage of lumbar cistern. Results among 49 cases, 5 cases received early postoperative surgery and 1 case died. 44 cases were treated with conservative therapy first. 30 cases were cured within 1 week after routine conservative treatment. 14 cases had no obvious improvement in 1 week. 8 cases were cured by continuous drainage and 6 cases had no significant reduction of cerebrospinal fluid leakage after 2 W drainage. 5 cases were treated with delayed cerebrospinal fluid leakage repair and 1 case with secondary intracranial infection. He recovered from the second operation. Conclusion: through correct treatment, the majority of traumatic cerebrospinal fluid leakage patients can obtain satisfactory results by conservative treatment. Patients with severe fracture, large amount of intracranial hematoma and obvious cerebrospinal fluid leakage often need early surgical treatment. Delayed cerebrospinal fluid leakage repair should be performed for the patients who have been treated with conservative therapy for 3 W to prevent the disease from prolonging and worsening.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.1

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