胸椎减压内固定术后脊髓硬膜外血肿原因分析及对策  

Analysis and prevention of spinal epidural hematoma following thoracic spine decompression and internal fixation

作　　者：谭荣[1] 马华松[1] 周建伟[1] 陈志明[1] 张峥[1] 陈阳[1] 

机构地区：[1]解放军第306医院骨科,全军脊柱外科中心,北京100101

出　　处：《临床骨科杂志》2010年第3期260-262,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨胸椎减压内固定术后脊髓硬膜外血肿的形成原因及其预防和治疗措施。方法分析3例胸椎减压内固定术后并发脊髓硬膜外血肿、出现脊髓压迫症状的临床资料,予再次急诊手术探查并行血肿清除减压术。结果术后患者出现的首发症状均是神经症状的加重,肌力进行性下降。急诊行血肿清除,术后6个月神经症状仅1例完全恢复。结论胸椎减压内固定术后脊髓硬膜外血肿相对少见,但后果严重。一旦发现脊髓压迫症状较术前加重,应尽早急诊手术。Objective To study the causes,diagnosis,treatment and prevention of spinal epidural hematoma（SEH）after decompression and internal fixation of thoracic spine.Methods A retrospective study was done on cases that underwent decompression and internal fixation of thoracic spine in our hospital.3 cases had SEH after the primary surgery and were treated by hematoma evacuation and decompression.Results The initial symptom was neurological deterioration,only 1 case recovered completely 6 months after surgery.Conclusions SEH after decompression and internal fixation of thoracic spine diseases appears relatively rare but may have serious consequences.Re-intervention must be performed as soon as possible once neurological deterioration was found.

关 键 词：胸椎 减压术 外科 血肿 硬膜外 脊髓 内固定 截瘫 

分 类 号：R687.3[医药卫生—骨科学] R651.154[医药卫生—外科学]