后颅窝肿瘤合并脑积水患者围手术期脑积水的处理.

Objective To investigate the reasonable treatment effect of perioperative hydrocephalus in patients with posterior fossa tumor. Methods The clinical data of 241 patients who underwent resection of posterior fossa tumors were analyzed retrospectively, of which 14 patients were excluded because of postoperative complications with other systemic infections. The patients with posterior fossa tumor complicated with hydrocephalus were divided into preoperative lumbar cistern drainage 1（ PLCFD1） group（ 22 cases） and no preoperative lumbar cistern drainage 1（ NPLCFD1） group（ 45 cases）. 227 patients with posterior fossa tumors were divided into preoperative lumbar cistern drainage 2（ PLCFD2） group（ 43 cases） and no preoperative lumbar cistern drainage 2（ NPLCFD2） group（ 184 cases）. The clinical data of the two groups were compared and analyzed. Results In this group,67 patients with posterior cranial fossa tumor complicated with hydrocephalus, and the remission rate of hydrocephalus was 94. 0%.The remission rate of early postoperative hydrocephalus in PLCFD1 group（ 86. 4%） was significantly higher than that in NPLCFD1 group（ 62. 2%）（ P = 0. 043）. The postoperative intracranial infection rate in PLCFD2 group（ 23. 3%）was significantly lower than that in NPLCFD2 group（ 41. 3%）（ P = 0. 028）. There was no significant difference in antibiotic use time between PLCFD2 group[14（ 10. 75-20. 50） d]and NPLCFD2 group [17（ 13. 25-22. 75） d]（ P = 0. 134). Conclusions Surgical treatment of hydrocephalus is not recommended in patients with posterior cranial fossa tumors complicated with hydrocephalus, except for obvious acute intracranial hypertension and ineffective drug treatment; In the patients with subtotal resection or above, only a small number of patients with hydrocephalus need further surgical treatment. Proper lumbar cistern drainage during and after operation can promote the early clearance of inflammatory and bloody cerebrospinal fluid in patients with posterior fossa tumor complicated with hydrocephalus after tumor resection, so as to reduce the incidence of postoperative hydrocephalus and reduce the incidence of intracranial infection after posterior fossa tumor resection. [ABSTRACT FROM AUTHOR]