腰椎术后硬膜外血肿致马尾综合征六例临床分析  

Clinical analysis on 6 cases of cauda equina syndrome due to spinal epidural hematoma following lumbar surgery

作　　者：李安军[1] 卜志勇[1] 李锦华[1] 李锐[1] 王伟[1] 施永彦[1] 曾小军[1] 

机构地区：[1]湖北医药学院附属人民医院脊柱外科,湖北十堰442000

出　　处：《海南医学》2013年第12期1815-1817,共3页Hainan Medical Journal

摘　　要：目的通过分析6例腰椎术后患者硬膜外血肿形成致马尾综合征的诊治过程,为临床诊治提供诊疗依据。方法回顾性分析2009年3月至2012年1月间腰椎术后经MRI证实有硬膜外血肿形成致马尾综合征患者的诊治资料,分析腰椎术后硬膜外血肿形成致马尾综合征的原因、临床表现、诊断方法、手术时机和预后。结果所有6例患者均行椎管探查、止血和血肿清除术,术后平均随访时间12个月(6～20个月),所有患者的神经功能均获得一定程度的恢复。结论腰椎术后硬膜外血肿形成致马尾综合征是一个严重的手术并发症,术中止血彻底,引流通畅,术后严密观察,及时手术探查是预防和治疗的有效措施。Objective To analyze 6 cases of cauda equina syndrome due to spinal epidural hematoma following lumbar surgery in order to provide experience for clinical work. Methods The clinical data of 6 cases of cauda equina syndrome due to spinal epidural hematoma following lumbar surgery were confirmed by MRI. The cause, clinical manifestation, diagnosis, treatment and prognosis were analyzed. Results All the patients underwent surgery exploration, hemostasia and hematoma removal. During the follow-up of 6 to 20 months （12 month in average）, neuro-logical function of patient was observed with complete or incomplete recovery. Conclusion Cauda equina syndrome due to spinal epidural hematoma following lumbar surgery was a serious complication. Hemostasia and correct drainage in the operation, close observation following operation and surgery exploration in time are the basic measures to prevent and treat spinal epidural hematoma.

关 键 词：腰椎手术 硬膜外血肿形成 马尾综合征 神经功能障碍 

分 类 号：R687.3[医药卫生—骨科学]