摘要
急性自发性椎管内硬膜外血肿(ASSEH)是一种罕见的自发性出血急症,因其起病隐匿、症状不典型,极易导致临床误诊、漏诊,若延误诊断和治疗,可导致神经功能不可逆损害,甚至危及生命。该文报道了1例因“胸痛2 h”入院的青年女性患者,无诱因出现背部疼痛,逐渐放射至心前区,呈进行性加重刺痛,初步诊断为胸痛查因:急性心肌梗死(AMI)?患者就诊过程中出现双下肢麻木、无力,大小便失禁。完善心电图、CT/核磁共振成像(MRI)及实验室等相关辅助检查,结合患者临床表现明确诊断,急诊手术后好转出院。现对该病例进行报道,探讨ASSEH患者临床特征及诊疗经验,旨在提高临床医务人员对该疾病的认识。
Acute spontaneous spinal epidural hematoma(ASSEH)is a rare spontaneous hemorrhagic emergency.Its insidious onset and atypical symptoms often lead to clinical misdiagnosis or missed diagnosis.Delayed diagnosis and treatment can result in irreversible neurological damage or even life-threatening consequences.We report a case of a young female patient who was admitted with"chest pain for 2 hours".She presented with unexplained back pain that progressively radiated to the precordial area,manifesting as intensifying sharp pain.The initial suspected diagnosis was acute myocardial infarction(AMI).During treatment,the patient developed numbness and weakness in both lower limbs,along with urinary and fecal incontinence.Based on electrocardiogram,CT/MRI,laboratory tests,and clinical manifestations,a definitive diagnosis of ASSEH was established.The patient improved after emergency surgery and was discharged.This case report discusses the clinical features,diagnostic process,and management of ASSEH,aiming to improve recognition of this condition among clinicians.
作者
魏萍
白芳
赵振宇
赵亚娟
张娜
张华
Wei Ping;Bai Fang;Zhao Zhenyu;Zhao Yajuan;Zhang Na;Zhang Hua(Nursing School of Hainan Medical University,Haikou 571199,China)
出处
《中国急救医学》
2026年第2期118-121,共4页
Chinese Journal of Critical Care Medicine
基金
海南省自然科学基金项目(822MS071)
海南省重点研发项目(ZDYF2022SHFZ306)。
