[1]周迎春　王　旋　邢细红　项宇飞　赵洪洋.自发性硬脊膜外血肿15例诊治分析[J].中国临床神经外科杂志,2020,(06):341-343.[doi:10.13798/j.issn.1009-153X.2020.06.002]
　ZHOU Ying-chun,WANG Xuan,XING Xi-hong,et al.Diagnosis and treatment of spontaneous spinal epidural hematoma (report of 15 cases)[J].,2020,(06):341-343.[doi:10.13798/j.issn.1009-153X.2020.06.002]
点击复制

自发性硬脊膜外血肿15例诊治分析()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年06期
页码:
341-343
栏目:
论著
出版日期:
2020-06-15

文章信息/Info

Title:
Diagnosis and treatment of spontaneous spinal epidural hematoma (report of 15 cases)
文章编号:
1009-153X（2020）06-0341-03
作者:
周迎春　王　旋　邢细红　项宇飞　赵洪洋
430022 武汉，华中科技大学同济医学院附属协和医院神经外科（周迎春、王　旋、项宇飞、赵洪洋）；434000 湖北，荆州市第二人民医院神经外科（邢细红）
Author(s):
ZHOU Ying-chun1;  WANG Xuan1;  XING Xi-hong2;  XIANG Yu-fei1;  ZHAO Hong-yang1.
1. Department of Neurosurgery, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430022, China; 2. Department of Neurosurgery, The Second People’s Hospital of Jingzhou City, Jingzhou 434000, China
关键词:
自发性硬脊膜外血肿; 临床特点; 显微手术
Keywords:
Spontaneous spinal epidural hematoma;  Clinical characteristics;  Diagnosis;  Microsurgery
分类号:
R 744.1
DOI:
10.13798/j.issn.1009-153X.2020.06.002
文献标志码:
A
摘要:
目的 探讨自发性硬脊膜外血肿（SSEH）的临床特点、治疗方法及效果。方法 回顾性分析2015年3月至2019年11月收治的15例SSEH的临床资料，保守治疗1例，手术治疗14例：椎板减压血肿清除10例，其中行脊柱固定融合7例，血肿清除后椎板还纳1例，半椎板入路血肿清除3例。结果 首次发病9例，两次以上6例。1例保守治疗ASIA分级由入院时C级恢复至出院时E级，后来失访。手术治疗的14例术后随访3个月~4年：4例术前ASIA分级A级中，1例术后随访3个月时仍为A级，随后失访；1例术后2年恢复至D级，2例术后3个月均恢复至E级；术前ASIA分级B~D级的10例术后3个月全部恢复至E级。13例3个月以后随访没有再发病，MRI复查未见复发；X线检查未见脊柱畸形和内固定松动。结论 部分SSEH有反复发病的特点，尽早手术可改善病人预后，不同的病例应该个体化选择手术方式
Abstract:
Objective To explore the clinical characteristics, and the diagnostic and therapeutic methods of spontaneous spinal epidural hematoma (SSEH). Methods A retrospective analysis of the clinical data was performed in 15 patients with SSEH who were treated in our hospital from March 2015 to November 2019. Of 15 patients, 1 patient received conservative treatment and 14 reveived surgery. Results Of 15 patients, 9 patients had single episode and 6 had multiple episodes. The ASIA grade of 1 patient reveiving conservative treatment was recovered from grade C at admission to grade E at discharge, and then the patient was lost to follow-up. The follow-up results of 14 patients (range, 3 months to 4 years) receiving surgical treatment showed: 1 patients with ASIA grade A preoperatively was still grade A 3 months after the operation, and then lost to follow-up; 1 patients with ASIA grade A preoperatively was recovered to grade D 2 years after the operation, 2 patients 2 years after operation were recovered to grade E 3 months after the operation; 10 patients with ASIA grade B to D before surgery were recovered to grade E 3 months after the operation. Thirteen patients had no recurrence 3 months after the operation. X-ray examination showed no spinal deformity and loose internal fixation. Conclusion Some SSEH have the characteristics of recurrent attacks. Early operation can improve the prognosis of the patients with SSEH, and individual surgery should be chosen for different patients

参考文献/References:

[1] Holtas S, Heiling M, Lonntoft M. Spontaneous spinalepidural hematoma: findings at mr imaging and clinical correlation [J]. Radiology, 1996, 199(2): 409-413.
[2] Yu JX, Liu J, He C, et al. Spontaneous spinal epidural he-matoma: a study of 55 cases focused on the etiology and treatment strategy [J]. World Neurosurg, 2017, 98: 546-554.
[3] Groen RJ. Non-operative treatment of spontaneous spinal epidural hematomas: a review of the literature and a comparison with operative cases [J]. Acta Neurochir (Wien), 2004, 146(2): 103-110.
[4] Kim T, Lee CH, Hyun SJ, et al. Clinical outcomes of sponta-neous spinal epidural hematoma: a comparative study between conservative and surgical treatment [J]. J Korean Neurosurg Soc, 2012, 52(6): 523-527.
[5] Dziedzic T, Kunert P, Krych P, et al. Management and neu-rological outcome of spontaneous spinal epidural hematoma [J]. J Clin Neurosci, 2015, 22(4): 726-729.
[6] Groen RJ, van Alphen HA. Operative treatment of sponta-neous spinal epidural hematomas: a study of the factors determining postoperative outcome [J]. Neurosurgery, 1996,39(3): 494-508.
[7] 闫　研，宋　健，黄　河，等. 自发性硬脊膜外血肿的诊治分析（附5例报告）[J]. 中国临床神经外科杂志，2016，1：7-9.
[8] Joaquim AF, Cheng I, Patel AA. Postoperative spinal defor-mity after treatment of intracanal spine lesions [J]. Spine J, 2012, 12(11): 1067-1074.
[9] Fu CF, Zhuang YD, Chen CM, et al. Spontaneous spinal epi-dural hematoma management with minimally invasive surgery through tubular retractors: a case report and review of the literature [J]. Medicine (Baltimore), 2016, 95(26): e3906(1-5).
[10] Wu ZY, Zhu YJ, Chu L, et al. Full-endoscopic transfora-minal approach for removal of a spontaneous spinal epiduralhematoma [J]. World Neurosurg, 2017, 98: 883 e13-e20.

相似文献/References:

[1]杨洪斌　索朗次仁　史　睿　吴京雷.西藏山南地区高血压脑出血的临床特点分析 （附39例报告）[J].中国临床神经外科杂志,2016,(05):300.[doi:10.13798/j.issn.1009-153X.2016.05.015]
[2]蒋　伟　孙守家　高　攀　张晓静　舒　凯　雷　霆　李　龄.异常椎基底动脉压迫致三叉神经痛的临床特点及显微手术治疗（附16例分析）[J].中国临床神经外科杂志,2016,(02):69.[doi:10.13798/j.issn.1009-153X.2016.02.002]
　JIANG Wei,SUN Shou-jia,GAO Pan,et al.Clinical features and microsurgical treatment of trigeminal neuralgia caused by abnormal vertebrobasilar artery compression (report of 16 cases)[J].,2016,(06):69.[doi:10.13798/j.issn.1009-153X.2016.02.002]
[3]闫　研　宋　健　黄　河　姚　顺　曹成龙　杜　浩　徐国政.自发性硬脊膜外血肿的诊治分析（附5例报告）[J].中国临床神经外科杂志,2016,(01):7.[doi:10.13798/j.issn.1009-153X.2016.01.003]
　YAN Yan,SONG Jian,HUANG He,et al.Diagnosis and treatment of spontaneous spinal epidural hematomas (report of 5 cases)[J].,2016,(06):7.[doi:10.13798/j.issn.1009-153X.2016.01.003]
[4]申汉威　李俊卿　李红星　姜志超　汪立刚　杨世春　杨孔宾.小儿颅脑损伤的临床特点及治疗分析[J].中国临床神经外科杂志,2015,(04):231.[doi:10.13798/j.issn.1009-153X.2015.04.013]
[5]旷仁钊　唐晓平　漆　建　苟章洋.小脑陈旧性血肿1例[J].中国临床神经外科杂志,2015,(04):255.[doi:10.13798/j.issn.1009-153X.2015.04.024]
[6]张　宁　杨华堂.青年人高血压脑出血的临床特点及治疗[J].中国临床神经外科杂志,2015,(02):103.[doi:10.13798/j.issn.1009-153X.2015.02.013]
[7]段勇刚　谭占国　袁　波.鞍区脑膜瘤不同手术入路疗效的对比分析[J].中国临床神经外科杂志,2017,(04):239.[doi:10.13798/j.issn.1009-153X.2017.04.011]
　DUAN Yong-gang,TAN Zhan-guo,YUAN Bo..Curative effects of neurosurgery on suprasellar and parasellar meningiomas: supraobital lateral approach versus pterional approach[J].,2017,(06):239.[doi:10.13798/j.issn.1009-153X.2017.04.011]
[8]张申起,彭彬,陈治标,等.脊髓室管膜瘤的临床特点及显微手术治疗[J].中国临床神经外科杂志,2017,(07):454.[doi:10.13798/j.issn.1009-153X.2017.07.003]
　ZHANG Shen-qi,PENG Bin,CHEN Zhi-biao,et al.Clinical features and microsurgical management of intramedullary spinal cord ependymomas[J].,2017,(06):454.[doi:10.13798/j.issn.1009-153X.2017.07.003]
[9]张申起　彭　彬　陈治标　田道锋　王军民　刘宝辉　杨吉安　陈谦学.局灶性脑干胶质瘤的临床特点及显微手术治疗[J].中国临床神经外科杂志,2017,(09):609.[doi:10.13798/j.issn.1009-153X.2017.09.001]
　ZHANG Shen-qi,PENG Bin,CHEN Zhi-biao,et al.Clinical features and microsurgical management of focal brainstem gliomas[J].,2017,(06):609.[doi:10.13798/j.issn.1009-153X.2017.09.001]
[10]张治元　王汉东　樊友武　贾　玥　吴晋蓉.胶质肉瘤15例分析及文献复习[J].中国临床神经外科杂志,2018,(02):69.
　ZHANG Zhi-yuan,WANG Han-dong,FAN You-wu,et al.Diagnosis and treatment of gliosarcoma: a report of 15 cases and literature review[J].,2018,(06):69.

备注/Memo

备注/Memo:
（2020-03-01收稿，2020-03-18修回）通讯作者：赵洪洋，E-mail：hyzhao750@sina.com
更新日期/Last Update: 2020-06-15