摘要
目的：探讨急性硬脊膜外血肿的病因、临床诊治特点。方法：分析近15年来经手术治疗的38例急性硬脊膜外血肿的病因、临床表现、MRI／DSA影像学及显微手术特点。结果：38例病人均行MRI检查。28例直接手术清除血肿；10例行DSA检查，6例先行硬脊膜动静脉瘘（AVF）供血动脉栓塞．再手术清除血肿并切除瘘口。1例患者术前诊断急性硬脊膜外血肿，术后病理证实为脊髓结核急性期。随访2～9年。神经系统恢复到正常情况的13例；有轻度神经系统改变但生活可以自理的19例；需他人帮助者4例；2例因血肿压迫时间长。术后双下肢瘫痪及尿潴留未改善；本组无死亡病例。结论：急性硬脊膜外血肿的早期诊断和早期治疗是提高疗效的关键。脊髓MRI检查是诊断急性硬脊膜外血肿的首选方法，清除血肿减轻其对脊髓的压迫是治疗本病的唯一有效方法，大的、高血流量的AVF术前栓塞供血动脉可减少术中出血。
Objective： This retrospective study was performed to research the causes, characteristic of diagnosis and treatment of the acute spinal epidural hematoma and to evaluate the result of operation. Methods： The authors studied 38 patients with acute spinal epidural hematoma who underwent surgical treatment. 10 of these patients underwent DSA and found 6 patients with perimedullary arteriovenous fistulas （AVFs）. All patients underwent surgery, and six patients underwent surgery combined with preoperative embolization. Results： Postoperatively, neurological status was recoverd in 13 patients and improved in 19 patients, 4 patients need help, and unchanged in 2 patients. Conclusions： Early diagnosis and surgical treatment of acute spinal epidural hematoma is the key to get satisfied results. For large and high-flow AVFs, embolization is proved to be useful to surgery. MRI findings are useful in establishing the diagnosis of acute spinal epidural hematoma.
出处
《脑与神经疾病杂志》
2007年第1期10-12,共3页
Journal of Brain and Nervous Diseases
关键词
急性
硬脊膜外
血肿
acute spinal epidural hematoma
