靶向硬膜外自体血介入术用于多区域脑脊液漏致自发性颅内低压治疗的临床效果:36例总结

摘要

目的 多区域脑脊液漏致自发性颅内低压患者36例,其中30例患者实施2次,6例患者实施3次靶向硬膜外自体血介入治疗后临床症状完全缓解.自体血注射过程中,发生24例穿刺部位注射痛、5例上肢放射性疼痛、9例上肢麻木、6例下肢疼痛、7例下肢麻木、4例头痛,3例头晕,3例一过性心动过缓;上述不良反应多数在停止注射自体血或减慢注射速度后缓解,部分在数小时后缓解;2例颈部僵硬感,术后数小时至数天后缓解,未见严重神经系统并发症.治疗结束后3个月2例复发,再次靶向硬膜外自体血介入治疗后缓解.术后随访15～ 36月,均未见严重神经系统并发症.由此可见,靶向硬膜外自体血介入术用于多区域脑脊液漏致自发性颅内低压的治疗是安全、有效的.%Thirty-six spontaneous intracranial hypotension patients with multiple-level leakages of cerebrospinal fluid were enrolled in the study.After 30 patients received targeted epidural blood intervention for 2 times and 6 patients received targeted epidural blood intervention for 3 times,the clinical symptoms were completely relieved.During injection of autologous blood,pain at the puncture site occurred in 24 cases,radiating pain in upper extremities in 5 cases,numbness in the upper extremity in 9 cases,radiating pain in lower extremities in 6 cases,numbness in lower extremities in 7 cases,headache in 4 cases,dizziness in 3 cases and transient bradycardia in 3 cases.Most of these symptoms were self-relieved after the end of injection or after slowing the injection rate,and some were self-relieved hours later.Neck stiffness was found in 2 cases and self-relived within a few hours or days after operation,and no severe nervous systemrelated complications were found.Recurrence happened in 2 cases at 3 months after the end of treatment,and the symptoms were self-relieved after receiving targeted epidural blood intervention for a second time.The patients were followed up for 15-36 months,and no serious nervous system-related complications were observed.Therefore,targeted epidural blood intervention is safe and effective when used to treat spontaneous intracranial hypotension caused by multiple-level leakages of cerebrospinal fluid in patients.