CT引导下硬膜外自体血补丁治疗自发性难治性低颅压头痛临床效果  

Clinical efficacy of CT-guided epidural autogenous blood patch in treatment of spontaneous refractory intracranial hypotension headache

作　　者：单鹄声 张博 肖越勇 张肖 何晓锋 张欣 魏颖恬 杨杰 李婕 张忠亮 薛晓东 张啸波 SHAN Husheng;ZHANG Bo;XIAO Yueyong;ZHANG Xiao;HE Xiaofeng;ZHANG Xin;WEI Yingtian;YANG Jie;LI Jie;ZHANG Zhongliang;XUE Xiaodong;ZHANG Xiaobo(Department of Diagnostic Radiology,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Department of Oncology,Huai'an Medical District,General Hospital of the Eastern Theater,Huai'an 223001,China;Department of Radiology,Integrated Traditional Chinese and Western Medicine Hospital,Changchun 132000,China)

机构地区：[1]中国人民解放军总医院第一医学中心放射诊断科,北京100853 [2]东部战区总医院淮安医疗区肿瘤科,江苏淮安223001 [3]吉林省中西医结合医院放射科,吉林长春132000

出　　处：《中国介入影像与治疗学》2020年第4期202-206,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：解放军总医院科技创新苗圃基金项目(18KMZ03)。

摘　　要：目的观察CT引导下硬膜外自体血补丁(EBP)治疗自发性难治性低颅压头痛的有效性及安全性。方法回顾性分析接受CT引导下EBP治疗的12例自发性难治性低颅压头痛患者的临床及影像学资料,统计手术前后疼痛视觉模拟评分(VAS)及并发症情况。结果12例患者共接受19次CT引导下EBP治疗,其中7例因术后1周VAS≥3分而接受2次EBP治疗。5例患者术后出现与体位无关的颈部局限性疼痛,1周内自愈;无其他严重并发症。术后各时间点患者VAS均较术前降低(P均<0.01),临床症状缓解或消失,随访3个月未见复发。结论CT引导下EBP治疗自发性难治性低颅压头痛疗效较好,安全性较高。Objective To observe the efficacy and safety of CT-guided epidural blood patch(EBP)in treatment of spontaneous refractory intracranial hypotension headache.Methods Clinical and imaging data of 12 patients with spontaneous intracranial hypotension headache treated with CT-guided EBP were retrospectively analyzed,and visual analogue scale(VAS)and complications were calculated before and after procedures.Results A total of 12 patients received 19 CT-guided EBP therapy,among which 7 patients received secondary EBP therapy.Five patients had postoperatively localized neck pain unrelated to body position,and then healed spontaneously within 1 week.No serious complication occurred.VAS of all patients at each time point after operation was lower than that before operation(all P<0.01),and the clinical symptoms relieved or disappeared after operation.No recurrence was detected during 3 months'follow-up.Conclusion CT-guided EBP is effective and safe in treatment of spontaneous refractory intracranial hypotension headache.

关 键 词：头痛 脑脊液漏 体层摄影术 X线计算机 自发性低颅压头痛 硬膜外自体血补丁 

分 类 号：R741[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]