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目的总结鼻内镜下外伤性脑脊液鼻漏修补术的经验。方法分析1991年9月￣2002年12月采用鼻内镜下修补外伤性脑脊液鼻漏患者49例资料。介绍了修补术的方法,并就脑脊液鼻漏的诊断,手术适应证、手术时机及手术中的关键问题等进行了讨论。结果内镜下外伤性脑脊液鼻漏修补术一次成功治愈占95.9%(47/49),失败的1例经第2次鼻内镜手术后治愈。最后的鼻内镜手术治愈率为98.0%;其中1例为额窦后壁创伤内镜下手术失败后改为鼻外进路修补成功。有1例伴有外伤性梗阻性脑积水患者,术后出现颅高压的并发症,抢救成功。结论鼻内镜下修补术是外伤性脑脊液鼻漏的首选外科治疗方法。
Objective To summarize the experience of endoscopic traumatic cerebrospinal fluid rhinorrhea repair. Methods From September 1991 to December 2002, 49 cases of rhinorrhea patients with traumatic cerebrospinal fluid rhinorrhea under nasal endoscopy were analyzed. The method of repair was introduced and the diagnosis of cerebrospinal fluid rhinorrhea, indications of operation, timing of operation and key problems in operation were discussed. Results Endoscopic traumatic cerebrospinal fluid rhinorrhea repair a successful cure accounted for 95.9% (47/49), failed in 1 case after the second endoscopic surgery cured. The final cure rate of endoscopic sinus surgery was 98.0%; one of them was retro-nasal approach to repair the frontal sinus posterior wall injury endoscopic surgery failed. One patient with traumatic obstructive hydrocephalus, postoperative complications of intracranial hypertension, rescue success. Conclusion Endoscopic repair is the first choice of surgical treatment of traumatic cerebrospinal fluid rhinorrhea.