人工硬膜治疗脊柱后路手术中脑脊液漏

目的 探讨人工硬膜覆盖硬膜囊漏口治疗脊柱后路手术中脑脊液漏的临床疗效.方法 回顾性分析海军军医大学长征医院2016年1月—2018年12月脊柱后路手术中发生脑脊液漏的101例患者临床资料,根据治疗方案分为对照组(n=56,术中采用明胶海绵覆盖硬膜囊漏口)和试验组(n=45,术中采用可吸收人工硬膜覆盖硬膜囊漏口).观察2...

Artificial dura in treatment of cerebrospinal fluid leakage during posterior spinal surgery

Objective To investigate the clinical efficacy of artificial dura in the treatment of cerebrospinal fluid leakage during posterior spinal surgery. Methods From January 2016 to December 2018, 101 patients with cerebrospinal fluid leakage during posterior spinal surgery in Changzheng Hospital of Navy Medical University were retrospectively analyzed. According to the treatment plan, they were divided into control group(n=56, gelatin sponge was used to cover the dural sac leakage) and experiment group(n=45, absorbable artificial dural was used to cover the dural sac leakage). The incidence of postoperative cerebrospinal fluid leakage, incidence of postoperative complications, drainage volume within 48 h after operation, retention time of drainage tube and incision healing time were observed and compared between the 2 groups. Results In the control group, the incidence of postoperative cerebrospinal fluid leakage was 76.79%, the incidence of postoperative complications was 32.14%, the drainage volume within 48 h after operation was (352.55±75.11)mL, the retention time of drainage tube was (7.55±2.38)d, and the incision healing time was (15.78±2.36)d. In the experiment group, the incidence of postoperative cerebrospinal fluid leakage was 15.56%, the incidence of postoperative complications was 6.67%, the drainage volume within 48 h after operation was (160.02±50.05)mL, the retention time of drainage tube was (1.87±0.69)d, and the incision healing time was (14.16±1.89)d. The incidence of postoperative cerebrospinal fluid leakage, incidence of postoperative complications, drainage within 48 h after operation, retention time of drainage tube and incision healing time in the experiment group were significantly better than those in the control group, and all with a statistical significance(P < 0.05). Conclusion Artificial dura can significantly reduce the incidence of postoperative cerebrospinal fluid leakage and related complications, significantly shorten the retention time of drainage tube and incision healing time, thus being an effective method for the treatment of cerebrospinal fluid leakage in posterior spinal surgery.