椎管内麻醉后的神经并发症(附9例报道)

NERVOUS COMPLICATIONS FOLLOWING INTRATHECAL ANESTHESIA ( Report of 9 Cases )

本文报道9例椎管内麻醉后的神经并发症。其中穿刺污染并发化脓性脑脊炎3例;麻醉药用量过大、浓度过高对脊髓或神经产生毒性损害1例;硬膜外空剌(或置管)损伤脊神经根或脊髓造成肢体感觉障碍或运动障碍、局部疼痛或瘫痪3例;穿刺损伤椎管静脉丛引起硬膜外腔出血、血肿压迫脊髓引起截瘫2例。本文结合病例对发生原因、临床表现、治疗及转归进行分析讨论。

Nine patients with nervous complications following intrathecal anesthesia were reported. These patients were complicated by pyogenic meningitis due to contamination caused by puncture. One patient had toxic damage to the spinal cord or nerve because of overdosage and hyperconsistency of narcotics for spinal anesthesia, in three of the nine patients the epidural puncture injured the root of the spinal nerve or spinal cord resulting in sensation disturbance or motor disturbance of the limbs, local pain or paralysis. The two remaining patients developed hemorrhage and hematoma caused by puncture which compressed spinal cord resulting in paraplegia, in the epidural space because of damage to intrathecal venous plexus. In this study, the causes, clinical icatures, treatment and prognosis of the complications are also analysed and discussed.