Zheng Min, Tian Qilong, Wang Xuejiao, Liu Liqin, Deng Xiurui, Qu Yan, Cai Qing
Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi'an, China.
Front Neurosci. 2023 Feb 28;17:1124395. doi: 10.3389/fnins.2023.1124395. eCollection 2023.
Lumbar cistern blockage is a common complication of continuous lumbar cistern drainage. This paper analyzes the risk factors for lumbar cistern blockage drainage due to various causes and proposes a series of prevention and intervention measures to reduce blockage or improve recanalization after blockage.
The clinical data of 637 patients with various lesions who underwent lumbar cistern drainage in our hospital were retrospectively collected and analyzed. Perioperative clinical and imaging data were assessed. Variates were analyzed using univariate and multivariate logistic regression analyses.
A total of 13.7% (87/637) of patients had lumbar cistern blockage. Multivariate analysis revealed that drainage time (≥7 days), CSF volume <200 (mL/d), CSF leakage, and abnormal CSF properties were predictors of lumbar cistern blockage. Reducing the probability of lumbar cistern blockage can be achieved by repeatedly flushing, increasing the drainage flow and shortening the drainage time. The recanalization rate after blockage was 67.8% (59/87). After the drainage tube was removed, no complications related to the drainage tube occurred during the 1-week follow-up.
Lumbar cistern blockage is the main reason for poor drainage. Prevention or early intervention can effectively reduce the probability of blockage and achieve the purpose of drainage of cerebrospinal fluid.
腰大池堵塞是持续腰大池引流的常见并发症。本文分析了各种原因导致腰大池堵塞引流的危险因素，并提出一系列预防和干预措施以减少堵塞或改善堵塞后的再通情况。
回顾性收集并分析我院637例因各种病变行腰大池引流患者的临床资料。评估围手术期临床及影像学资料。采用单因素和多因素逻辑回归分析对变量进行分析。
共有13.7%（87/637）的患者发生腰大池堵塞。多因素分析显示，引流时间（≥7天）、脑脊液量<200（mL/d）、脑脊液漏及脑脊液性质异常是腰大池堵塞的预测因素。通过反复冲洗、增加引流量和缩短引流时间可降低腰大池堵塞的概率。堵塞后的再通率为67.8%（59/87）。拔除引流管后，1周随访期间未发生与引流管相关的并发症。
腰大池堵塞是引流效果不佳的主要原因。预防或早期干预可有效降低堵塞概率，达到脑脊液引流的目的。
