CAJ | 학술논문

目的：探讨颅内血肿合并脑脊液鼻漏急性期术中探查、修补手术指征。方法选取2004年10月至2010年12月收治的颅内血肿合并脑脊液鼻漏患者185例，根据颅底骨折位置将其分为颅前窝、颅中窝、颅后窝3种骨折类型，并根据不同类型总结其手术入路。结果185例患者治愈169例，死亡16例。10例患者术后仍有轻微脑脊液鼻漏，经保守治疗后脑脊液鼻漏停止。术后获随访82例，有3例脑脊液鼻漏复发，其中2例经保守治愈，1例再经蝶手术修补后治愈。结论颅内血肿同时合并颅底骨折脑脊液漏患者，手术时应注意同时行颅底探查、重建及脑脊液漏修补，可有效减少再次手术的概率。
목적：탐토로내혈종합병뇌척액비루급성기술중탐사、수보수술지정。방법선취2004년10월지2010년12월수치적로내혈종합병뇌척액비루환자185례，근거로저골절위치장기분위로전와、로중와、로후와3충골절류형，병근거불동류형총결기수술입로。결과185례환자치유169례，사망16례。10례환자술후잉유경미뇌척액비루，경보수치료후뇌척액비루정지。술후획수방82례，유3례뇌척액비루복발，기중2례경보수치유，1례재경접수술수보후치유。결론로내혈종동시합병로저골절뇌척액루환자，수술시응주의동시행로저탐사、중건급뇌척액루수보，가유효감소재차수술적개솔。
Objective To explore the operation indications of intraoperative exploration and repair in the acute stage of intracranial hematoma complicating cerebrospinal fluid rhinorrhea. Methods 185 patients with intracranial hematoma compli-cating cerebrospinal fluid rhinorrhea in our hospital from October 2004 to December 2010 were selected and divided into 3 types according to the basicranial fracture position. The operative approaches were summarized according to different types. Results Among 185 cases,169 cases were cured and 6 cases died. Mild cerebrospinal fluid rhinorrhea after operation still existed in 10 cases and were stopped by the conservation treatment. 82 cases were followed up , cerebrospinal fluid rhinorrhea reoccurred in 3 cases,2 cases were cured by the conservation treatment and 1 case was cured by trans-sphenoid operation. Conclusion For the patients with intracranial hematoma complicating basicranial fracture and cerebrospinal fluid leak ,the operation should pay atten-tion to simultaneously perform the basicranial exploration , reconstruction and cerebrospinal fluid repair ,which could reduce the chance of re-operation.