摘要
目的脑脊液漏为脊柱外科手术常见并发症,是导致切口难愈、硬脊膜出血以及颅内感染等主要原因。本研究探讨脊柱术后脑脊液漏患者发生近期并发症危险因素,并提出脑脊液漏的合理术后管理措施。方法选取中国医科大学附属盛京医院2017-01-01-2018-09-30术后出现脑脊液漏患者46例作为研究对象,根据是否发生近期并发症分为并发症组(10例)和无并发症组(36例),研究不同手术部位、损伤方式与发生近期并发症关系,并探讨近期并发症发生危险因素。结果手术部位和损伤方式与术后是否出现脑脊液漏无关联,均P>0.05。拔出时引流量(χ2=10.161,P=0.001)和术中是否缝合(χ2=6.986,P=0.008)与术后并发症发生有关联。Logistic回归分析结果显示,拔出时引流量≥41mL(OR=16.145,95%CI为2.206~118.134,P=0.006)是发生近期并发症的危险因素;术中缝合情况(OR=0.101,95%CI为0.015~0.679,P=0.018)是发生近期并发症的保护因素。结论出现脑脊液漏时,待引流量<41mL时再予拔除引流管,并予术中硬脊膜缝合以避免近期并发症的发生。
OBJECTIVE Cerebrospinal fluid leakage is a common complication of spinal surgery,and it is the main cause of incision dysfunction,dural hemorrhage,and intracranial infection.This study explores the risk factors of recent complications in patients with cerebrospinal fluid leakage after spinal surgery,and proposes reasonable postoperative management measures for cerebrospinal fluid leakage.METHODS A total of 46 patients with cerebrospinal fluid leakage after Shengjing Hospital of China Medical University from January 01,2017 to September 30,2018 were selected as the research object,and they were divided into complications group(10 cases)and the uncomplicated group(36 cases),the relationship between different surgical sites,injury methods and recent complications was studied,and the risk factors of recent complications were discussed.RESULTS The operation site and injury method were not related to whether cerebrospinal fluid leakage occurred after operation,both P>0.05.The drainage volume(χ~2=10.161,P=0.001)and sutured or not during the operation(χ~2=6.986,P=0.008)were associated with postoperative complications.Logistic regression analysis showed that the drainage volume≥41 ml at the time of extraction was a risk factor for recent complications(OR=16.145,95%CI:2.206-118.134,P=0.006).Intraoperative sutures was the most recent complication protection factors(OR=0.101,95%CI:0.015-0.679,P=0.018).CONCLUSION When cerebrospinal fluid leakage occurred,the drainage tube was removed when the drainage volume was less than 41 ml,and the dura mater was sutured during the operation to avoid recent complications.
作者
朱美达
李雷
ZHU Mei-da;LI Lei(Department of Orthopedics,Shengjing Hospital of China Medical University,Shenyang110004,P.R.China)
出处
《社区医学杂志》
2020年第15期1059-1061,共3页
Journal Of Community Medicine
关键词
脑脊液漏
引流量
术中缝合
手术部位
损伤方式
cerebrospinal fluid leakage
drainage
intraoperative suture
surgical site
injury method
作者简介
第一作者:朱美达,男,内蒙古赤峰人,硕士,主治医师,主要从事脊柱外科研究工作。Tel:86-24-81687669,E-mail:lnzmdjiayou@163.com;通信作者:李雷,男,辽宁沈阳人,博士,教授,主任医师,主要从事脊柱外科研究工作。Tel:86-24-81687669,E-mail:lnzmdjiayou@163.com
