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硬脊膜外脓肿4例临床分析

Clinical analysis of spinal epidural abscess

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【作者】 姚林冯鸣王杭州杨天权赵国政干文娟周幽心

【Author】 YAO Lin;FENG Ming;WANG Hang-zhou;The First Affiliated Hospital of Soochow University;

【通讯作者】 周幽心;

【机构】 苏州大学第一附属医院神经外科苏州大学附属儿童医院苏州大学第一附属医院病理科

【摘要】 目的探讨硬脊膜外脓肿的临床症状、影像学表现及治疗方法和预后。方法回顾性分析苏州大学附属第一医院自2013年1月—2017年11月收治的4例硬脊膜外脓肿患者(男1例,女3例)的临床资料。其中2例完全瘫痪患者未行手术治疗,予以抗感染、脱水等对症治疗;另2例未完全瘫痪患者行手术治疗。结合文献复习分析该病的临床特点、治疗方法及预后。结果 4例患者均表现脊柱疼痛、发热、肢体运动障碍等临床症状。2例未完全截瘫患者经手术及药物治疗后,症状均改善; 2例完全截瘫患者治疗后无明显效果。结论硬脊膜外脓肿的治疗效果及预后与病程缓急、患者全身状况及脊髓受压情况、手术是否及时等有密切关系。早期诊断、早期治疗对硬脊膜外脓肿患者的治疗效果和预后极为重要。

【Abstract】 Objective To investigate the clinical symptoms,imaging findings,treatment and prognosis of spinal epidural abscess. Methods The clinical data of 4 patients of epidural abscess( 1 male and 3 female) who admitted in First Hospital Affiliated to Suzhou University from January 2013 to November 2017 were analyzed retrospectively. 2 patients with complete paraplegia were treated with anti-infective treatment infection,dehydration and other symptomatic treatments instead of surgical treatment. 2 patients with incomplete paraplegia underwent surgery. The clinical characteristics,treatment and prognosis of spinal epidural abscess were discussed. Results All 4 patients had clinical symptoms such as spinal pain,fever and limb movement restriction. The symptoms of 2 patients with incomplete paraplegia were improved after drug treatment and surgical treatment. 2 patients with complete paraplegia had no obvious effect after treatment. Conclusions The treatment and prognosis of epidural abscess are closely related to the course of disease,the general condition of patients,the condition of spinal cord compression and the operation time. Early diagnosis and treatment are very important for treatment and prognosis of patients with epidural abscess.

【关键词】 硬脊膜外脓肿抗生素手术治疗
【Key words】 epidural abscessantibioticssurgical treatment
【基金】 江苏省卫生计生委科研课题(Q201606);苏州市“科教兴卫”青年科技项目(KJXW2016020)
  • 【文献出处】 临床神经外科杂志 ,Journal of Clinical Neurosurgery , 编辑部邮箱 ,2019年01期
  • 【分类号】R651.2
  • 【下载频次】80
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