膜外穿刺脑脊液漏处理的研究进展（Research progress of cerebrospinal fluid leakage treatment by external puncture）.docVIP

膜外穿刺脑脊液漏处理的研究进展（Research progress of cerebrospinal fluid leakage treatment by external puncture） Chinese anesthesia online, , September 2007 Research progress of cerebrospinal fluid leakage treatment by external puncture Research progress of cerebrospinal fluid leakage treatment by external puncture Xiao Fei Zhang Jin Xiao Fei Zhang Jin Department of Anesthesiology; Shengjing Hospital of China Medical University Department of Anesthesiology; Shengjing Hospital of China Medical University Post dural, puncture, headache, PDPH) after dural puncture is due to the puncture of dura mater in the process of membrane puncture Postoperative headache caused by leakage of cerebrospinal fluid (CSF) is often seen in 6~72h after puncture, with the incidence rate of 30%-76.5%[1]. This kind of head [2] Pain affects daily life and can even lead to intracranial subdural hematomas. Most PDPH are cured within a week or are eliminated after proper treatment [1][3] Over 1.5 years of history. Dura mater is a dense connective tissue, with less vascular distribution and poor blood supply. It usually takes two weeks to heal after injury. Subarachnoid space [5] The cerebrospinal fluid pressure is higher, while the epidural pressure is low, the pressure difference between the two cavities, the dura puncture, continuous cerebrospinal fluid outflow, causing the brain ridge Decrease of liquid pressure. The mechanism may be as follows: first, when the upright position is located, the cerebrospinal fluid pressure is low, causing intracranial hyperalgesia, and the structure is pulled down and the brain tissue sinks, The sinking oppression occiput, supporting structure of the twelve cranial nerve and brain, especially at the base of the meninges, tentorium and vascular tension caused by various [4] Symptom。 Second, cerebrospinal fluid loss is compensated by epidural and intra membrane venous plexus volume, resulting in diffuse membrane swelling and venous plexus congestion [10][18]. This phenomenon re