支气管动脉插管并发脊髓损伤治疗的再探讨

Therapy of spinal cord injury in catheterization of bronchial arteries

目的:探讨支气管动脉插管中并发脊髓动脉损伤的有效治疗方法。方法:对选择性支气管动脉造影(BAG),支气管动脉灌注化疗(BAI)及支气管动脉栓塞(BAE)中出现脊髓损伤的11例分别采取普通方法和推荐方法治疗。结果:用普通方法治疗的4例中1例永久性截瘫,2例单侧下肢麻木,肌力下降为Ⅲ～Ⅳ级,1例基本恢复。用推荐方法治疗的7例中除2例遗留右下肢肌力Ⅳ+级外,其余5例均基本恢复。结论:脊髓损伤治疗时间窗为术后5小时内,早期贯序性应用扩血管药、足量激素、脱水剂、神经营养药能有效地治疗脊髓动脉损伤,并使之恢复正常。

Objective:To discuss effective therapy of spinal cord injury in catheterization of bronchial arteries.Methods:Eleven cases complicated with spinal cord injury during BAG,BAI and BAE were treated with common therapy or recommendatory therapy.Results:Four cases were treated with common therapy,in these cases,one case resulted in permanent paraplegia,two cases with unilateral lower limb numbness,lower limb strength Ⅲ～Ⅳ grade,one case recovered,seven cases were treated with recommendatory therapy,among them,two cases with right lower limb strength Ⅳ+ grade,five cases recovered.Conclusion:Cases with spinal cord injury should be treated effectively within five hours.Early use of vasodilators,enough glucocorticoids,dehydrators,neuronutrients is effective to spinal cord injury.