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在内镜内外科手术后使用选择的外科手术期间腰部排水管的安全概况

Danielle Wishart¹, Mehrdad Pahlevani¹, David J Cote¹

¹Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

Operative neurosurgery (Hagerstown, Md.)

|June 30, 2025

概括

腰部排水 (LDs) 在复杂的内镜内外科手术 (EES) 中用于脑脊液 (CSF) 的转移. 虽然LD患者通常耐受良好,但需要密切监测潜在并发症,特别是那些患有大型侵入性瘤的患者.

科学领域:

神经外科神经外科
头骨底部手术头骨底部手术
内視鏡外科手術內視鏡外科手術

背景情况:

腰部排水 (LDs) 在复杂的内镜内外科手术 (EES) 中被选择性地使用,以管理脑脊液 (CSF) 的转移并降低泄漏率.
在EES中插入LD的术后结果和安全概况需要详细调查.

研究的目的:

为了评估与外科手术期间腰部排水装置安置相关的安全概况和并发症率,在接受前头骨底部瘤EES的患者中.

主要方法:

在2014年1月至2023年12月期间,对690名患者进行了前底瘤的EES后期审查.
根据手术前使用或不使用LDs的情况,患者被分为两类.
对LD患者的排水相关并发症和结果进行了分析.

主要成果:

在690名患者中,有141名 (20.4%) 患者接受了LD,主要是扩展EES (81.6%) 和复杂的病理,如垂体腺瘤和膜瘤.
手术后的脊髓液泄漏率和脑膜炎率分别为16.3%和3.6%,脑膜炎率与非脑膜炎组相比没有显著差异.
与插入相关的并发症发生在3.7%的LD患者中,包括阻塞,多次尝试和过度排水,没有长期后果. 移除LD没有任何并发症.

结论:

在EES的腰部排水位置与患有更大,更具侵入性的瘤和高流量手术内CSF泄漏的患者有关.
虽然LD在这个高风险队列中通常耐受良好,但密切监测患者并发症至关重要.

关键词:

在CSF泄漏.腰部下水道的排水.下垂体腺瘤是什么意思

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