氟骨病胸椎管狭窄症手术后血肿形成的早期诊断和治疗

目的分析氟骨病胸椎管狭窄症手术后伤口血肿形成的原因,总结早期诊断和治疗的方法。方法采用后路全椎板减压术治疗312例氟骨病胸椎管狭窄症患者,术后短期内出现神经症状恶化并经MRI检查证实为血肿形成18例,一经确诊马上实施血肿清除术。结果所有病例二次手术后神经症状均获得不同程度的恢复,得到早期诊断、早期治疗的病例恢复效果明显优于延迟治疗的病例。结论手术后血肿形成是氟骨病胸椎管狭窄症治疗中的一种严重并发症,只有早期诊断、及时手术清除才能获得满意的效果。

Early diagnosis and treatment of postoperative spinal epidural hematoma after laminectomy for fluorosis thoracic canal stenosis

Objective To classify the etiology of postoperative spinal epidural hematoma(PSEH) after laminectomy for fluorosis thoracic canal stenosis(FTCS)so that to detect the methods of early diagnosis and treatment.Methods 312 cases of FTCS underwent laminectomy, in which 18 cases who presented with gradual neural deterioration during early stage after operation were final diagnosed as postoperative spinal epidural hematoma (PSEH) depending on the MRI. Second operations were performed in all cases for treatment.Results All cases acquired neurological development after second operation especially for those who have gotten early diagnosis and treatment.Conclusions PSEH is one of the most hazardous complication for patients with FTCS, only early diagnosis and operational treatment could guarantee satisfied clinical outcomes.