自发性脊髓硬膜外血肿的早期诊断和治疗

Early Diagnosis and Treatment of Spontaneous Spinal Epidural Hemotomas

目的 :探讨自发性脊髓硬膜外血肿 (SSEH)的早期诊断和治疗的方法及意义。方法 :对 5例SSEH患者的诊断和治疗经过进行回顾性分析。结果 :2例诊断和手术较早的患者恢复较理想 ,2例诊断和手术较晚的患者恢复较差 ,1例症状较轻 ,行保守治疗 ,自行恢复。结论 :SSEH发病率低 ,由于缺乏认识 ,有时造成诊断和治疗上的延误 ,影响脊髓神经功能的恢复。有典型症状者应尽早行MRI检查 ,明确诊断。有脊髓压迫症的患者 ,尽早行血肿清除术对脊髓神经功能的恢复有重要意义。症状轻 ,停止进展或有恢复迹象者应行保守治疗。

Objective: Our aim was to study the methods and significance of early diagnosis and treatment of spontaneous spinal epidural hemotomas(SSEH). Methods: A retrospective analysis of 5 patients with SSEH was performed. Results: Favorable postoperative functional results were found in 2 patients with early diagnosis and treatment.Unfavorable postoperative functional results were found in 2 patients without early diagnosis and treatment. Non operative therapy was performed on 1 patient with mild symptoms. Conclusions: The results demonstrate both the superiority of MRI for diagnosis of SSEH and necessity of early decompressive surgery in cases of sensorimotor paralysis after SSEH. Non operative therapy may be appropriate in patients with mild symptoms or neurological recovery.