颈椎硬膜外血贴治疗是自发性颅内低血压的一种选择。

IF 1.4 4区医学 Q4 ENGINEERING, BIOMEDICAL

Technology and Health Care Pub Date : 2024-08-29 DOI:10.3233/thc-241366

Hui Su,Xiaoyang Lan,Ya Cao,Mingjie Zhang,Xiaoyan Chen,Chen Lan

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引用次数: 0

摘要

背景硬膜外血贴（EBP）是治疗自发性颅内低血压（SIH）的一种微创、有效的方法。方法：2014 年 8 月至 2024 年 3 月，中国人民解放军总医院对 59 例难治性 SIH 患者进行了计算机断层扫描（CT）引导下的颈椎 EBP 检查。结果59 例患者发病时的平均年龄为（40.8±9.5）岁。54/59（91.5%）名患者出现过正中型头痛。43/46（93.5%）例患者术前脊柱 T2 囊肿，上颈部有大量积液。45/59（76.3%）名患者在最初的颈椎 EBP 治疗后症状得到缓解，14/59（23.7%）名患者接受了进一步的颈椎 EBP 治疗。在 EBP 术后的一至三天内，11 名患者（18.6%）报告穿刺部位疼痛，15 名患者（25.4%）报告颈部疼痛。术中和术后均未发现其他并发症。在最近的随访中，所有患者均恢复良好。结论：CT 引导下的颈椎 EBP 是治疗顽固性 SIH 患者的一种有效而安全的方法，尤其适用于上颈部有大量积液的患者。

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Cervical epidural blood patch treatment is a choice for spontaneous intracranial hypotension.

BACKGROUND Epidural blood patch (EBP) is a minimally invasive and effective treatment for spontaneous intracranial hypotension (SIH). But, cervical epidural blood patch for SIH has little attention. OBJECTIVE In this study, The clinical data was recorded and the treatment efficacy and safety of cervical EBP in SIH were evaluated. METHODS : Fifty-nine cases of intractable SIH were examined by computed tomography (CT) guided cervical EBP at the Chinese PLA General Hospital from August 2014 to March 2024. RESULTS The mean age of the fifty-nine patients at symptom onset was 40.8 ± 9.5 years. 54/59 (91.5%) patients experienced orthostatic headache. Preoperative spine T2 sacns with extensive fluid collection at the upper cervical region in 43/46 (93.5%). 45/59 (76.3%) patients had symptomatic relief with initial cervical EBP, and 14/59 (23.7%) patients received further cervical EBPs. In the first one to three days following the EBP procedure, 11 (18.6%) patients reported pain at the puncture site and 15 (25.4%) experienced neck pain. No other complications were observed during or after the procedure. At the latest follow-up, all patients showed good recovery. The mean follow-up was 28.9 ± 22.7 months. CONCLUSION CT-guided cervical EBP is a effective and safe treatment for patients with intractable SIH, especially in patients who had extensive fluid collection at the upper cervical region.

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来源期刊

Technology and Health Care HEALTH CARE SCIENCES & SERVICES-ENGINEERING, BIOMEDICAL

CiteScore

2.10

自引率

6.20%

发文量

282

审稿时长

>12 weeks

期刊介绍： Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured. The main focus of THC is related to the overlapping areas of engineering and medicine. The following types of contributions are considered: 1.Original articles: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine. In particular, the clinical benefit deriving from the application of engineering methods and devices in clinical medicine should be demonstrated. Typically, full length original contributions have a length of 4000 words, thereby taking duly into account figures and tables. 2.Technical Notes and Short Communications: Technical Notes relate to novel technical developments with relevance for clinical medicine. In Short Communications, clinical applications are shortly described. 3.Both Technical Notes and Short Communications typically have a length of 1500 words. Reviews and Tutorials (upon invitation only): Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented. The Editorial Board is responsible for the selection of topics. 4.Minisymposia (upon invitation only): Under the leadership of a Special Editor, controversial or important issues relating to health care are highlighted and discussed by various authors. 5.Letters to the Editors: Discussions or short statements (not indexed).