早期腰大池持续脑脊液外引流术在儿童后颅窝肿瘤切除术中的应用

纪文元; 梁平; 李禄生; 翟瑄; 周渝冬

doi:10.16016/j.1000-5404.201710045

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早期腰大池持续脑脊液外引流术在儿童后颅窝肿瘤切除术中的应用

临床医学 | 更新时间：2026-01-09

- 早期腰大池持续脑脊液外引流术在儿童后颅窝肿瘤切除术中的应用
- Application of early continuous lumbar cerebrospinal fluid drainage in children after resection of posterior cranial fossa tumors
- 第三军医大学学报 2018年40卷第5期页码：454-458
- 作者机构：
  
  400014 重庆，重庆医科大学附属儿童医院神经外科，儿童发育疾病研究教育部重点实验室，儿童发育重大疾病国家国际科技合作基地，儿科学重庆市重点实验室
- 作者简介：
  
  [周渝冬，E-mail：zhouyudong999@163.comZHOU Yudong, E-mail: zhouyudong999@163.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201710045
  中图分类号： R726.15;R730.56;R739.41
- 收稿：2017-10-11，
  
  修回：2017-12-04，
  
  纸质出版：2018-03-15
- 稿件说明：
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纪文元, 梁平, 李禄生, 等. 早期腰大池持续脑脊液外引流术在儿童后颅窝肿瘤切除术中的应用[J]. 第三军医大学学报, 2018,40(5):454-458.

Wenyuan JI, Ping LIANG, Lusheng LI, et al. Application of early continuous lumbar cerebrospinal fluid drainage in children after resection of posterior cranial fossa tumors[J]. Journal of Third Military Medical University, 2018, 40(5): 454-458.
纪文元, 梁平, 李禄生, 等. 早期腰大池持续脑脊液外引流术在儿童后颅窝肿瘤切除术中的应用[J]. 第三军医大学学报, 2018,40(5):454-458. DOI： 10.16016/j.1000-5404.201710045.

Wenyuan JI, Ping LIANG, Lusheng LI, et al. Application of early continuous lumbar cerebrospinal fluid drainage in children after resection of posterior cranial fossa tumors[J]. Journal of Third Military Medical University, 2018, 40(5): 454-458. DOI： 10.16016/j.1000-5404.201710045.

摘要

目的

探讨早期采用腰大池持续脑脊液外引流术(continuous lumbar cerebrospinal fluid drainage，CLCFD)对儿童后颅窝肿瘤切除术后的治疗效果。

方法

回顾性分析重庆医科大学附属儿童医院神经外科2013年1月到2016年7月收治的137例合并脑积水的后颅窝肿瘤患儿术后情况。研究分2组：CLCFD组(63例)在肿瘤切除术后即刻行CLCFD；常规治疗组(74例)在肿瘤切除术后行连续腰椎穿刺。比较两组患者的治疗结果。

结果

与常规治疗组比较，CLCFD患儿颅内感染率(

=0.031)、皮下积液发生率(

=0.006)、脑积水发生率(

=0.036)显著降低，术后发热＞7 d(

0.01)、颅内感染者抗生素使用＞10 d(

=0.021)例数显著减少。

结论

在后颅窝肿瘤术后早期采用CLCFD能减少患儿颅内感染、脑积水、皮下积液的发生率，缩短发热时间和抗生素的使用时间，手术简便、创伤小、并发症少，值得临床广泛应用。

Abstract

Objective

To investigate the efficacy of early continuous lumbar cerebrospinal fluid drainage (CLCFD) in children after the resection of posterior cranial fossa tumors.

Methods

A retrospective study was carried out on 137 children suffering from posterior cranial fossa tumor with hydrocephalus admitted in our department from January 2013 to July 2016. Their clinical data and postoperative therapeutic experience were collected and analyzed. The children were divided into CLCFD group (

=63

undergoing CLCFD immediately after tumor resection) and conventional group (

=74

accepting routine lumbar puncture postoperatively). The efficacy was observed and compared between the 2 groups.

Results

Compared with the conventional group

the CLCFD group had significantly lower incidence rates of intracranial infection (

=0.031)

subcutaneous hydrops (

=0.006)

and hydrocephalus (

=0.036)

and decreased ratios of those with postoperative fever over 7 d (

0.01) and usage of antibiotics for over 10 d due to intracranial infection (

=0.021).

Conclusion

Early CLCFD after resection of posterior cranial fossa tumor can reduce the incidence of intracranial infection

hydrocephalus and subcutaneous hydrops

shorten the duration of fever and decrease the usage of antibiotics. The approach is easy to operate

with mild trauma and less complications

and worthy of extensive application in clinical practice.

关键词

Keywords

references

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