硬脊膜穿破后头痛的研究进展

Research advances in postdural puncture headache

硬脊膜穿破后头痛(PDPH)是椎管内麻醉的并发症之一,通常发生在意外硬脊膜穿破后、蛛网膜下腔阻滞有意的硬脊膜穿破后,或其他诊断性、治疗性硬脊膜穿破后。PDPH的临床表现为体位性钝痛或搏动性头痛,并伴障碍性听觉和(或)视觉症状,还可能伴随一系列并发症,包括慢性头痛、背痛、颅神经功能障碍、硬膜下血肿和脑静脉窦血栓等。本文就目前关于PDPH病理生理学、危险因素、预防及治疗方法的研究进展进行综述,以期为临床提供参考。

Postdural puncture headache(PDPH)is a common complication of neuraxial anesthesia.It can occur after accidental dural puncture during epidural anesthesia,intentional dural puncture for spinal anesthesia,or other diagnostic or therapeutic procedures involving dural puncture.Clinically,PDPH presents as postural dull or pulsating headaches,often accompanied by auditory and(or)visual symptoms.It can also be associated with potential complications such as chronic headaches,back pain,cranial nerve dysfunction,subdural hematoma,and cerebral venous sinus thrombosis.This article reviews current researches on the pathophysiology,risk factors,prevention,and treatment of PDPH,aiming to provide a reference for clinical practice.