[1]祝　源　杨　铭　潘　力　马廉亭.脊髓静脉高压综合征的病因分析及避免误诊的对策[J].中国临床神经外科杂志,2019,(01):1-9.[doi:10.13798/j.issn.1009-153X.2019.01.001]
　ZHU Yuan,YANG Ming,PAN Li,et al.Analysis of etiology and countermeasures to avoid misdiagnosis of spinal venous hypertensive myelopathy[J].,2019,(01):1-9.[doi:10.13798/j.issn.1009-153X.2019.01.001]
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脊髓静脉高压综合征的病因分析 及避免误诊的对策()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年01期
页码:
1-9
栏目:
论著
出版日期:
2019-01-25

文章信息/Info

Title:
Analysis of etiology and countermeasures to avoid misdiagnosis of spinal venous hypertensive myelopathy
文章编号:
1009-153X（2019）01-0001-09
作者:
祝　源　杨　铭　潘　力　马廉亭
Author(s):
ZHU Yuan1; 2;  YANG Ming1;  PAN Li1;  MA Lian-ting1.
1. Department of Neurosurgery, General Hospital, Central Command, PLA, Wuhan 430070, China; 2. Department of Neurosurgery, Guanggu Hospital Area, The Third Hospital of Wuhan City, Wuhan 430074, China
关键词:
脊髓静脉高压综合征; 血管内治疗; 显微手术; 疗效; 误诊
Keywords:
Spinal venous hypertensive myelopathy;  Endovascular treatment;  Surgical procedures;  Outcome
分类号:
R744.1;R651.1+2
DOI:
10.13798/j.issn.1009-153X.2019.01.001
文献标志码:
A
摘要:
目的 探讨脊髓静脉高压综合征的病因及避免误诊的对策。方法 回顾性分析94例脊髓静脉高压综合征病人的临床资料，包括神经系统症状，体征，影像学资料和手术记录等，根据病变的供血动脉和引流静脉特点将病因分为六大类。对其中外院误诊的近1/3病人，我们采取了非常规造影方法，全部明确了诊断，进行了治疗。结果 脊髓静脉高压综合征由脊髓供血动脉病变引起80例；由非脊髓供血动脉向脊髓静脉引流8例；其中，颈内动脉供血2例，颈外动脉供血3例，髂内动脉供血3例；椎旁静脉狭窄，导致静脉回流受阻，向脊髓静脉引流6例。其中，血管内治疗67例，开放手术27例，治愈30例，好转47例，无变化17例。结论 脊髓静脉高压综合征是由多种类型脑脊髓血管病变引起，常被误诊和漏诊，对本文近1/3误诊病人，我们在诊断上采用了一些独特的造影方法而解决了误诊、漏诊，取得较好的效果。
Abstract:
Objective To explore the etiology and the countermeasures to avoid misdiagnosis of spinal venous hypertensive myelopathy. Methods The clinical data of 94 patients with spinal venous hypertensive myelopathy, including neurological symptoms and signs, imaging data and surgical records, were retrospectively analyzed. The etiology was divided into six categories according to the characteristics of the blood supply artery and drainage vein. The difinite diagnoses were made for nearly one-third of the patients who were misdiagnosed in the external hospital by unconventional angiography methods, and all these patients were treated correspondingly. Results Of 94 patients with spinal venous hypertensive myelopathy, 80 patients were caused by spinal cord blood supply artery lesions, 8 by drainage from non-spinal artery to spinal cord vein including 2 internal carotid artery blood supply, 3 external carotid artery blood supply and 3 internal iliac artery blood supply, 6 by drainage to the spinal vein resulting from paravertebral vein stenosis. Sixty-seven patients were treated with endovascular treatment, and 27 with open surgery. Thirty patients were cured, 47 improved, and 17 unchanged. Conclusions Spinal venous hypertensive myelopathy, which is often misdiagnosed and missed, is a disease causing by many types of cerebrospinal vascular disease. For nearly 1/3 misdiagnosing patients, we use some unique angiography methods to solve misdiagnosis and missed diagnosis.

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备注/Memo

备注/Memo:
doi：10.13798/j.issn.1009-153X.2019.01.001
作者单位：430070 武汉，中国人民解放军中部战区总医院神经外科、中国人民解放军神经外科研究所、国家重点学科神经外科外科[祝　源（现在武汉市第三医院光谷院区神经外科工作）、杨　铭、潘　力、马廉亭] 通讯作者：马廉亭，E-mail：mlt1937@163.com
更新日期/Last Update: 2019-01-25