持续加压包扎结合早期拔管治疗胸腰椎术后脑脊液漏的临床评价

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  目的 评价切口持续加压包扎结合早期拔管治疗胸腰椎术后脑脊液漏的临床效果.方法 本组脑脊液漏42例,男性18例,女性24例.年龄12 ~ 71岁,平均32岁.先天性脊柱侧凸合并骨嵴12例,胸椎管狭窄症8例,腰椎管狭窄症13例,腰椎间盘突出症5例,腰椎滑脱症4例.A组35例术中行硬脊膜切开或硬脊膜破裂,其中29例术中行硬脊膜修补,术中严密缝合切口,切口放置大棉垫用腹带持续加压包扎至引流管拔出后3天,术后3天切口无渗出,拔除引流管,如果切口渗出脑脊液,切口丝线间断缝合无渗出3天后拔出引流管;B组7例术中未发现脑脊液漏而术后发现脑脊液漏,发现脑脊液漏后采取上述方法处理.术后抗生素预防感染5-7天,观察切口愈合时间、切口感染和假性硬脊膜囊肿等并发症.
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