摘要
目的总结经历误诊的脊髓静脉高压综合征(SVHS)患者的护理经验。方法回顾性分析1998~2024年中部战区总医院神经外科收治的34例经历误诊的SVHS患者的临床资料,总结护理经验。结果34例中,误诊为脊髓炎10例,椎间盘突出或椎管狭窄15例,前列腺肥大5例,其他疾病4例。误诊时间最长达3年。入院后,34例均明确诊断:14例硬脊膜动静脉瘘,6例硬脑膜动静脉瘘,3例硬脊膜外动静脉瘘,3例左肾静脉狭窄,3例左侧第三腰横静脉膜样狭窄,1例左侧髂内动脉动静脉畸形,1例胡桃夹综合征,左、右髂内动脉动静脉瘘各1例;另1例辗转各大医院行全面检查未发现脊髓血管病、随访20年仍有双膝关节以下肌力减弱、但肌萎缩未加重。入院后,给予针对性个体化护理,包括术前心理支持、围手术期的护理、术后并发症预防及康复指导,显著改善了患者的预后。结论经历误诊的SVHS患者,给予针对性个体化护理能够有效改善患者预后和生活质量,而长期康复指导对患者脊髓神经功能的恢复具有重要意义。
Objective To summarize the nursing experience for patients with spinal venous hypertensive syndrome(SVHS)who experienced misdiagnosis.Methods The clinical data of 34 patients with misdiagnosed SVHS admitted to the Department of Neurosurgery,General Hospital of Central Theater Command from 1998 to 2024 were retrospectively analyzed,and nursing experience was summarized.Results Among the 34 patients,10 were misdiagnosed with myelitis,15 with intervertebral disc herniation or spinal stenosis,5 with prostatic hyperplasia,and 4 with other diseases.The longest duration of misdiagnosis reached 3 years.After admission,all 34 patients were definitively diagnosed:14 with spinal dural arteriovenous fistula,6 with intracranial dural arteriovenous fistula,3 with spinal epidural arteriovenous fistula,3 with left renal vein stenosis,3 with left third lumbar transverse venous membranous stenosis,1 with left internal iliac artery arteriovenous malformation,1 with nutcracker syndrome,and 1 each with left and right internal iliac artery arteriovenous fistulas.One patient underwent comprehensive examinations in multiple hospitals but no spinal vascular disease was detected;follow-up over 20 years showed persistent muscle weakness below the knees without progression of muscle atrophy.After admission,targeted individualized nursing care was provided,including preoperative psychological support,perioperative nursing,prevention of postoperative complications,and rehabilitation guidance,significantly improving patient outcomes.Conclusion For patients with misdiagnosed SVHS,targeted individualized nursing care can effectively improve prognosis and quality of life,while long-term rehabilitation guidance is crucial for the recovery of spinal cord neurological function.
作者
周佳
彭娜
苏晓娟
黄河
夏敏
马廉亭
ZHOU Jia;PENG Na;SU Xiaojuan;HUANG He;XIA Min;MA Lianting(Department of Neurosurgery,General Hospital of Central Theater Command,Wuhan 430070,China)
出处
《中国临床神经外科杂志》
2025年第10期621-624,共4页
Chinese Journal of Clinical Neurosurgery
关键词
脊髓静脉高压综合征
误诊
护理
spinal venous hypertensive syndrome
misdiagnosis
nursing
