术后 CSF 渗漏:血贴--一条新路

Asian journal of neurosurgery Pub Date : 2023-12-29 eCollection Date: 2023-12-01 DOI:10.1055/s-0043-1768599
Geover Lobo, Sarita R J Lobo
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引用次数: 0

摘要

导言神经外科手术后脑脊液漏(CSF)是一种已知的并发症,可能导致不良后果(1)。脑脊液漏的发生率因手术部位而异,经蝶后窝手术的发生率从 4% 到 32% 不等。治疗术后 CSF 漏所需的费用呈指数增长,成为继续最佳治疗的障碍。有许多研究比较了不同的治疗方法,甚至是密封剂的使用,但都没有给出处理方法。我们的研究旨在了解有助于治疗这类低压 CSF 漏的技术。材料和方法 这是一项前瞻性研究,从 2014 年 1 月至 2019 年 1 月,为期 5 年。研究纳入了所有接受过硬脑膜切开术的患者。结果 共有 6 名患者被纳入研究。研究时间从 2014 年 1 月至 2019 年 1 月,为期 5 年。所有患者在获得知情同意后都接受了必要的检查,并进行了血贴。其中五名患者的 CSF 停止了,但一名患者的 CSF 仍在持续。这名患者再次接受了检查,并在影像引导下再次进行了血贴,之后 CSF 渗漏停止了。结论 影像引导下的血贴是一种安全、简单的技术。停止 CSF 渗漏的成功率很高。此外,使用自体移植物(患者的血液)也是一种经济有效的方法。
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Postoperative CSF Leak: Blood Patch-A New Avenue.

Introduction  Cerebrospinal fluid leak (CSF) after a neurosurgical procedure is a known complication that may result in bad outcomes (1). The incidence of CSF leak varies based on the site involved; it ranges from 4 to 32% for transsphenoidal to posterior fossa procedures. The costs involved in treating postoperative CSF leaks increases exponentially that becomes a barrier in continuing optimum treatment. There are many studies that compare the different treatment modalities and even use of sealing agents but none give an algorithm of management. Our study aims at known technique that can help to treat these kinds of low-pressure CSF leaks. Materials and Methods  This was a prospective study done over a period of 5 years from January 2014 to January 2019. All patients who underwent procedures in which durotomy was done were included in the study. Results  A total of six patients were enrolled for the study. The duration of the study spanned 5 years from January 2014 to January 2019. All the patients after taking informed consent underwent the necessary investigations and a blood patch was done. Five of the patients the CSF stopped but in one patient it persisted. This patient again underwent investigation and under image guidance another blood patch was put after which the CSF leak stopped. Conclusion  Blood patch under imaging guidance is a safe and simple technique. The success rates of cessation of CSF leaks are good. Also, it is a cost-effective method using an autograft (patient's blood).

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