摘要：

目的: 探讨内镜下扩大经鼻蝶入路脑脊液鼻漏修补术在基层医院的应用价值。方法与结果: 回顾分析2022年1月至2023年12月内蒙古自治区托克托县医院、准格尔旗人民医院、四子王旗人民医院共30例患者的临床资料，均接受内镜下扩大经鼻蝶入路脑脊液鼻漏修补术，采用标准化内镜手术技术和修补材料（如自体脂肪组织、筋膜或人工硬膜）。所有患者均顺利完成手术，平均手术时间为（73.00 ±15.90）min，平均术中出血量为（34.00 ±16.94）ml。术后并发症发生率为6.67%（2/30），包括短暂性脑脊液鼻漏1例和轻微鼻腔感染1例，均经保守治疗后治愈。平均住院时间为（7.43 ±2.06）d。术后平均随访（9.97 ±3.51）个月，3例（10%）复发，均经二次修补后治愈，最终治愈率为100%（30/30）。结论: 内镜下扩大经鼻蝶入路脑脊液鼻漏修补术在基层医院的应用具有较好的疗效和安全性，且节约医疗成本，值得推广。

关键词: 脑脊液鼻漏, 蝶窦, 神经内窥镜

Abstract:

Objective: To evaluate the clinical value of the endoscopic expanded endonasal transsphenoidal approach for cerebrospinal fluid rhinorrhea (CSFR) repair in primary hospitals. Methods and Results: A retrospective analysis was conducted on 30 patients between January 2022 and December 2023 at Togtoh County Hospital, Jungar Banner People's Hospital, and Siziwang Banner People's Hospital in Inner Mongolia Autonomous Region. All patients underwent endoscopic expanded endonasal transsphenoidal approach for CSFR repair using standardized endoscopic surgical techniques and repair materials (such as autologous fat, fascia, or synthetic materials). All procedures were successfully completed, with an average operative time of (73.00 ±15.90) min and intraoperative blood loss of (34.00 ±16.94) ml. The postoperative complication rate was 6.67% (2/30), including transient CSFR (one case) and mild nasal infection (one case), both of which resolved with conservative treatment. The average hospital stay was (7.43 ±2.06) d. During an average follow-up period of (9.97 ±3.51) months, recurrence occurred in 3 cases (10%), all of which were successfully cured with secondary repair, resulting in a final cure rate of 100% (30/30). Conclusions: The endoscopic expanded endonasal transsphenoidal approach for CSFR repair demonstrates favorable efficacy and safety in primary hospitals, along with cost-saving benefits, making it worthy of wider adoption.

Key words: Cerebrospinal fluid rhinorrhea, Sphenoid sinus, Neuroendoscopes