硬膜外镇痛失败产后并发颅内硬膜下血肿1例  

Epidural analgesia failure followed by intracranial subdural hematoma:a case report

作　　者：曾勇 王晓雯[1] 张续丰 王文 何文容[1] Zeng Yong;Wang Xiaowen;Zhang Xufeng;Wang Wen;He Wenrong(Department of Obstetrics,the First Hospital Affiliated to Yangtze University,Jingzhou First People's Hospital,Jingzhou 434000,China)

机构地区：[1]长江大学附属第一医院,湖北省荆州市第一人民医院产科,荆州434000

出　　处：《中华围产医学杂志》2022年第7期550-552,共3页Chinese Journal of Perinatal Medicine

摘　　要：本文报道1例硬膜外镇痛失败产后并发颅内硬膜下血肿的诊治过程。孕妇既往无头痛病史,孕期产前检查无明显异常,孕32周+6因先兆早产行硬膜外分娩镇痛时发生意外硬脊膜穿破。阴道分娩后第4天,产妇出现头痛,平卧时无法缓解,无其他神经系统症状,急查头颅CT示左侧额颞部硬膜下血肿。经甘露醇静脉点滴保守治疗后,产后第18天复查头颅CT示左侧额颞部硬膜下血肿较前基本吸收后出院,随访至今未诉不适。硬脊膜穿刺后并发颅内硬膜下血肿作为一种罕见而且严重并发症,及早识别和治疗至关重要。We report the diagnosis and treatment of a rare case of epidural analgesia failure followed by postpartum subdural hematoma.The patient underwent vaginal delivery under epidural analgesia at 32+6 gestational weeks due to threatened premature labor,during which an unexpected dural rupture occurred.She gave no history of headache and there was no obvious abnormality during the pregnancy.However,on postpartum day 4,the patient complained of headache that could not be relieved when supine,but without any other neurological symptoms.A prompt cranial CT examination showed a left frontotemporal subdural hematoma.After conservative management with intravenous drip of mannitol,re-examination of cranial CT showed that the left frontotemporal subdural hematoma was mostly absorbed and the patient was discharged on postpartum day 18.The patient was healthy during follow up.Intracranial subdural hematoma after dural puncture is a rare and serious complication that requires early recognition and treatment.

关 键 词：镇痛 硬膜外 镇痛 产科 血肿 硬膜下 颅内 

分 类 号：R714.3[医药卫生—妇产科学]