自发性硬脊膜外血肿的诊治分析(附5例报告)  

Diagnosis and treatment of spontaneous spinal epidural hematomas (report of 5 cases)

作　　者：闫研[1] 宋健[1] 黄河[1] 姚顺[1] 曹成龙[1] 杜浩[1] 徐国政[1] 

机构地区：[1]广州军区武汉总医院神经外科,武汉430070

出　　处：《中国临床神经外科杂志》2016年第1期7-9,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨自发性硬脊膜外血肿的临床特点和诊治方法。方法2011年10月至2014年11月收治5例自发性硬脊膜外血肿患者，入院时按神经功能按美国脊髓损伤学会分级标准，A级、B级各1例，c级2例，D级1例；手术4例，保守治疗1例。出院后随访3个月～3年。结果本组无死亡病例。出院后3个月按GOS评分均预后良好；按脊髓损伤的Frankel分级，c级1例，D级4例；无复发。结论MRI检查可明确显示自发性硬脊膜外血肿情况；对于神经功能障碍较重、血肿量较大的患者应手术治疗并行椎管探查；对于血肿量小且有消融趋势的患者可考虑保守治疗。Objective To explore the clinical features and treatment of the spontaneous spinal epidural hematomas （SSEDH）. Methods The clinical data of 5 patients with SSEDH treated from October, 2011 to November, 2014 were analyzed retrospectively. The neurological dysfunction was evaluated by International Standards for Neurological Classification of Spinal Cord Injury of Americal Spinal Injury Association （ASIA）. ASIA grade was A in 1 patient, B in 1, C in 2 and D in 1 on admission to hospital. Everyone received the MRI examination. Of 5 patients, 4 were treated by surgery and 1 conservatively treated. The epidural vascular malformation was found in patient undergoing the surgery. Results All the patients were followed up from 3 to 36 months. Frankel grade was C in 1 patient and D in 4. Conclusions MRI examination should be performed in the SSEDH patients with severe spinal cord dysfunction or large hematomas. The SSEDH patients with small hematomas may be conservatively treated.

关 键 词：自发性硬脊膜外血肿 临床表现 诊断 治疗 

分 类 号：R744.11[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]