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患者男36岁,因再次行鼻息肉手术入院。两年前曾切除过大量息肉组织,双侧筛窦顶部亦切除。此次手术再次从双鼻孔取出大量息肉,术中注意到息肉侵蚀部分蝶窦前壁并进入窦内,除去息肉后怀疑蝶窦后壁亦有缺损,无脑脊液鼻漏。鼻内填塞物于术后第一天取出。术后28小时诉剧烈的前额部头痛,发烧(38℃),但神智清醒,无视乳头水肿或其他神经系统体征,头颅X线片示双侧脑室及第三脑室内存在气体;腰穿结果为多形核白细胞增多但培养无细菌生长。静脉给予氯霉素治疗,24小时内烧退。其后8天内继续有时
Male patient 36 years old, due to nasal polyps surgery again admitted to hospital. Two years ago had removed a large number of polyps, both sides of the top of the ethmoid sinus resection. The surgery once again removed a large number of polyps from the two nostrils, surgery to pay attention to the polyps erosion part of the anterior wall of the sphenoid sinus and enter the sinus, after removal of polyps suspected sphenoid sinus posterior wall also have defects, no cerebrospinal fluid rhinorrhea. Nasal stuffing was removed on the first postoperative day. Postoperative 28 hours complained of severe headache in the forehead, fever (38 ℃), but sober, ignoring the papillary edema or other signs of the nervous system, skull X-ray showed bilateral ventricle and third ventricle gas; lumbar puncture results Polymorphonuclear leukocytes increased but no bacterial growth. Intravenous chloramphenicol treatment, burning back within 24 hours. In the following 8 days to continue sometimes