Nusselder F A, Franke C L
De Wever-Ziekenhuis, afd. Neurologie, Heerlen.
Ned Tijdschr Geneeskd. 1990 Apr 21;134(16):808-11.
Femoral neuropathy resulting from iliopsoas muscle haematoma during anticoagulant therapy is described with reference to five patients. The clinical picture is stereotypic. The patient experiences sudden, excruciating pain in the inguinal area and flank radiating to the anterior section of the thigh. This is followed by weakness of the quadriceps muscle. Computed tomography is the method of choice to show the presence of an iliopsoas haematoma. To prevent serious and sometimes irreversible nerve damage the anticoagulant therapy should be stopped and antagonists should be given. Surgical decompression of the haematoma has been advocated, but this intervention has been done only in a few patients.
本文参考5例患者描述了抗凝治疗期间因髂腰肌血肿导致的股神经病变。临床表现具有典型性。患者腹股沟区和侧腹突发剧痛,并向大腿前部放射。随后股四头肌出现无力。计算机断层扫描是显示髂腰肌血肿存在的首选方法。为防止严重且有时不可逆转的神经损伤,应停止抗凝治疗并给予拮抗剂。有人主张对血肿进行手术减压,但仅对少数患者进行了这种干预。