Application of continuous lumbar cerebrospinal fluid drainage in cerebrospinal fluid leakage after severe craniocerebral injury

Abstract

Objective To investigate the treatment effect of continuous lumbar cerebrospinal fluid drainage(CLCFD)on patients with cerebrospinal fluid leakage after severe craniocerebral injury operation. Methods Fifty-two patients with postoperative cerebrospinal fluid leakage following severe traumatic brain injury admitted to the Intensive Care Unit, Qinghai Provincial People's Hospital from January 2014 to December 2014 were enrolled. According to the different treatment methods, the 52 patients were divided into either a routine lumbar puncture group(n=26)or a CLCFD group(n=26). The differences of the stop time of cerebrospinal fluid leakage, the clinical cure rate within 14 d, and the intracranial infection rate were compared in patients between the 2 groups. Results The stop time of cerebrospinal fluid leakage of the CLCFD group and the routine lumbar puncture group was 6.3±1.4 d and 12.2±2.1 d respectively(P<0.001). There was significant difference between the 2 groups. The cure rates of the CLCFD group and the routine lumbar puncture group within 14 d were 92%(24/26)and 77%(20/26)respectively. There was significant difference between the 2 groups(P<0.001). One patient(4%)had intracranial infection in the CLCFD group, and 8(31%)had intracranial infection in the routine lumbar puncture group. The incidence of intracranial infection of the CLCFD group was significantly lower than that of the routine lumbar puncture group(P<0.001). Conclusions Using early CLCFD for the treatment of postoperative cerebrospinal fluid leakage following severe traumatic brain injury may shorten the duration of cerebrospinal fluid leakage in patients, improve the clinical cure rate within 14 d, and decrease the incidence of intracranial infection. Its clinical efficacy is significantly superior to releasing cerebrospinal fluid of conventional lumbar puncture. Key words: Craniocerebral trauma; Lumbar cerebrospinal fluid drainage; Cerebrospinal fluid leakage