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在横向自发脑脊液 (CSF) 泄漏中脑内压力升高的发生率

Evan C Cumpston¹, William Zhang², Ritika S Bhadouriya²

¹Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, Indiana.

Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology

|March 13, 2025

概括

术后内高血压 (IH) 在中腔 (MCF) 修复侧向脑脊液 (CSF) 泄漏后的32%患者中发现. 几乎所有患者都患有阻塞性睡眠呼吸暂停 (OSA),高开口压力与较高的呼吸暂停-呼吸暂停指数 (AHI) 相相关.

科学领域:

神经外科神经外科
睡眠医学睡眠医学
神经学神经学

背景情况:

自发性脑脊液 (sCSF) 泄漏,特别是横向的泄漏,通常需要中腔 (MCF) 修复.
手术后的并发症和相关疾病,如内高血压 (IH) 和阻塞性睡眠呼吸暂停 (OSA),需要在此类修复后进行调查.

研究的目的:

通过腰部穿刺 (LP) 和多睡眠图 (PSG) 的发现,评估术后的开口压力 (OP) 在 MCF 修复后的患者中.
确定该患者队列中IH和OSA的患病率,并探索潜在的相关性.

主要方法:

在高等推中心进行的回顾性队列研究.
分析了因中枢神经液泄漏而接受MCF修复的患者的数据,其次是PSG和术后LP.
对IH患病率 (LP OP>25厘米H2O) 和OSA患病率 (呼吸暂停-呼吸暂停指数[AHI]>5) 的评估.

主要成果:

在72名患者中 (平均年龄为56.7岁,BMI为39.0公斤/米2),32%的患者表现出IH (LP OP ≥25厘米H2O).
阻塞性睡眠呼吸暂停 (OSA) 的患病率很高 (93%),平均AHI为25.6.
在AHI和升高的OP之间观察到正相关性;所有OP>25厘米H2O的患者的AHI>15.

结论:

由于横向sCSF泄漏而接受MCF修复的患者中有很大一部分 (32%) 发展为IH.
这个队列中的几乎所有患者都患有OSA,高OP与更高的AHI有关.
建议所有MCF修复后的患者进行常规的PSG. 术后LP建议那些有AHI>15,多焦点sCSF泄漏,或视觉症状.

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