腰大池引流治疗颈椎肿瘤术后脑脊液漏

发布时间：2018-12-15 09:17

【摘要】：目的分析持续腰大池引流治疗颈椎肿瘤术后脑脊液漏的临床效果。方法回顾性分析第二军医大学附属长征医骨肿瘤科2013年7月—2015年12月收治的接受颈椎肿瘤手术的264例患者资料(术后转至上海开元骨科医院继续治疗),其中颈椎肿瘤术后发生脑脊液漏并行持续腰大池引流的患者47例。24例患者因积极一般治疗后症状无明显缓解、13例伤口渗液明显、2例疑似合并颅内感染、8例2周的一般治疗后引流量仍较大而分别选择行腰大池引流。记录置管时间及引流时间,观察伤口愈合情况。结果所有患者经持续腰大池引流治疗后均获痊愈。持续引流7~43 d,平均13.8 d,腰大池置管时间为1~19 d,平均7.1 d。随访中有2例出现脑脊液囊肿,给予患者局部穿刺引流并局部加压包扎后治愈,其余无严重并发症。结论颈椎肿瘤术后脑脊液漏患者行持续腰大池引流治疗能有效控制患者不适症状,有助于伤口愈合,可预防和治疗颅内感染等,疗效确切。
[Abstract]:Objective to analyze the clinical effect of continuous lumbar cistern drainage in the treatment of cerebrospinal fluid leakage after cervical spine tumor operation. Methods the data of 264 patients who received cervical spine tumor surgery from July 2013 to December 2015 were retrospectively analyzed (transferred to Kaiyuan Orthopaedics Hospital, Shanghai) from July 2013 to December 2015. Among them, 47 patients with cerebrospinal fluid leakage and continuous lumbar cistern drainage occurred after operation of cervical spine tumor, 24 patients had no obvious relief after active general treatment, 13 patients had obvious wound exudation, and 2 patients suspected to be complicated with intracranial infection. After 2 weeks of general treatment, the drainage volume was still larger in 8 cases, and the drainage of the large lumbar cistern was performed separately. The time of tube placement and drainage were recorded and the wound healing was observed. Results all patients were cured after continuous lumbar cistern drainage. The drainage lasted for 7 days (13.8 days), and the time for placing tube in the large lumbar cistern was 1: 19 days, with an average of 7.1 days. Cerebrospinal fluid cysts were found in 2 cases. The patients were cured by local puncture and drainage and local compression bandage. There were no serious complications in the other cases. Conclusion continuous lumbar cistern drainage in patients with cerebrospinal fluid leakage after operation of cervical spine tumor can effectively control the symptoms of the patients, help the wound healing, prevent and treat intracranial infection and so on.
【作者单位】：第二军医大学附属长征医院骨肿瘤科;上海开元骨科医院骨肿瘤科;
【分类号】：R738.1

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