The treatment of subcutaneous cystic fluid useing lumbar drainage in syringomyelia postoperative
-
摘要:
目的分析腰大池置管引流脑脊液治疗脊髓空洞症术后皮下囊性积液的疗效。 方法回顾性分析我院自2010年7月~2014年7月间收治的28例脊髓空洞症术后皮下囊性积液的患者临床资料,其中19例采用腰穿置管腰大池引流及枕部加压包扎治疗,9例患者采用多次腰穿及枕部加压包扎治疗。 结果腰大池引流治疗组皮下囊性积液消失时间明显短于腰穿组(P < 0.05),两组并发症的比较差别无统计学意义(P>0.05)。 结论腰大池引流及枕部加压包扎治疗脊髓空洞症术后皮下囊性积液临床疗效优于传统的腰穿及枕部加压包扎,具有操作简便、创伤小、并发症少等优点,同时避免了手术修补硬膜带来的二次损伤。 Abstract:ObjectiveTo analyze and study the treatment of subcutaneous cystic fluid useing lumbar drainage in syringomyelia postoperative. MethodsRetrospective analysis 28 cases of subcutaneous cystic fluid of syringomyelia postoperative in patients since July 2010 to July 2014 in our hospital, including 19 cases of patients useing lumbar drainage and occipital bandaged treatment, nine cases of patients using multiple lumbar puncture and occipital bandaged treatment. ResultsThe disappearance of subcutaneous cystic fluid in lumbar drainage and occipital bandaged therapy group was significantly shorter than the multiple lumbar puncture and occipital bandaged group (P < 0.05), comparing the difference between the two groups was not statistically significant in complications (P>0.05). ConclusionThe clinical efficacy of lumbar drainage and occipital bandaged treatment of subcutaneous fluid after surgery of syringomyelia is better than traditional lumbar puncture and occipital bandaged, is a simple, less invasive, fewer complications methods, and avoiding secondary damage caused by surgical repair dura. -
Key words:
- lumbar drainage /
- syringomyelia /
- subcutaneous cystic fluid
-
表 1 28例患者的治疗效果对比表
分级 例数 脑脊液引流量(ml/d) 头痛持续时间(h) 皮下积液消失(d) 住院时间(d) 治愈率(%) 治疗组 19 180.0±102.5 5.5±2.6 5.6±1.3 16.1±1.7 100.0 对照组 9 15.5±13.6 12.4±4.5 10.5±2.5 24.4±2.6 88.9 P - < 0.01 < 0.01 < 0.01 < 0.05 < 0.01 表 2 两组患者并发症比较
组別 例数 颅内感染 继发癫痫 硬膜下积液 合计 治疗组 19 1 1 2 4 对照组 9 2 2 1 5 P - > 0.05 > 0.05 > 0.05 > 0.05 -
[1] Blegvad C1, Grotenhuis JA, Juhler M. Syringomyelia: a practical, clinical concept for classification[J]. Acta Neurochir (Wien), 2014, 156(11): 2127-38. doi: 10.1007/s00701-014-2229-z [2] Awai L, Curt A. Preserved sensory-motor function despite large-scale morphological alterations in a series of patients with holocord syringomyelia[J]. J Neurotrauma, 2015, 32(6): 403-10. doi: 10.1089/neu.2014.3536 [3] 张玉琪, 王忠诚, 马振宇, 等.小脑扁桃体切除并脊髓中央管口松解术治疗合并脊髓空洞的Chiari畸形[J].中华神经外科杂志, 2004, 20 (3): 32-4. http://www.cnki.com.cn/Article/CJFDTOTAL-ZHSW200403008.htm [4] Governale LS. Resolution of chiari-associated syringomyelia[J]. Pediatr Neurol, 2014, 50(5): 542-3. doi: 10.1016/j.pediatrneurol.2014.01.033 [5] 王汉斌, 苏亦兵.从小脑扁桃体下疝看Chiari畸形[J].中华神经外科疾病研究杂志, 2012, 11(6): 565-7. http://www.cnki.com.cn/Article/CJFDTOTAL-SJWK201206033.htm [6] Yeo NK, Cho GS, Kim CJ, et al. The effectiveness of lumbar drainage in the conservative and surgical treatment of traumatic cerebrospinal fluid rhinorrhea[J]. Acta Otolaryngol, 2013, 133(1): 82-90. https://www.ncbi.nlm.nih.gov/pubmed/22992063 [7] Klekamp J. Surgical treatment of Chiari I malformation--analysis of intraoperative findings, complications, and outcome for 371 foramen magnum decompressions[J]. Neurosurgery, 2012, 71(2): 365-80; discussion 380. doi: 10.1227/NEU.0b013e31825c3426 [8] Liang CJ, Dong QJ, Xing YH, et al. Posterior fossa decompression combined with resection of the cerebellomedullary fissure membrane and expansile duraplasty: a radical and rational surgical treatment for Arnold-Chiari type I malformation[J]. Cell Biochem Biophys, 2014, 70(3): 1817-21. doi: 10.1007/s12013-014-0135-x [9] Mehta GU, Oldfield EH. Prevention of intraoperative cerebrospinal fluid leaks by lumbar cerebrospinal fluid drainage during surgery for pituitary macroadenomas[J]. J Neurosurg, 2012, 116(6): 1299-303. doi: 10.3171/2012.3.JNS112160 [10] 董继烈, 莫万彬, 陈五金, 等.腰大池置管持续引流在神经外科中的应用[J].临床合理用药杂志, 2010, 3(22): 87-8. http://www.cnki.com.cn/Article/CJFDTOTAL-PLHY201022079.htm [11] Abulhasan YB, Al-Jehani H, Valiquette MA, et al. Lumbar drainage for the treatment of severe bacterial meningitis[J]. Neurocrit Care, 2013, 19(2): 199-205. doi: 10.1007/s12028-013-9853-y
点击查看大图
表(2)
计量
- 文章访问数: 568
- HTML全文浏览量: 217
- PDF下载量: 2
- 被引次数: 0