颈椎硬膜外血贴治疗是自发性颅内低血压的一种选择。

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research 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

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.