颈椎脊髓损伤患者更换耻骨上导尿管引发的严重、持续性膀胱痉挛和自主神经反射异常：鞘内注射巴氯芬大剂量推注及增加每日总剂量的治疗方法
Severe, Protracted Spasm of Urinary Bladder and Autonomic Dysreflexia Caused by Changing the Suprapubic Catheter in a Cervical Spinal Cord Injury Patient: Treatment by a Bolus Dose and Increased Total Daily Dose of Intrathecal Baclofen.
作者信息
Vaidyanathan Subramanian, Oo Tun, Soni Bakul M, Hughes Peter L, Singh Gurpreet
机构信息
Regional Spinal Injuries Centre, Southport and Formby District General Hospital, Southport, UK.
Department of Radiology, Southport and Formby District General Hospital, Southport, UK.
出版信息
Clin Med Insights Case Rep. 2016 Dec 13;9:119-121. doi: 10.4137/CCRep.S39117. eCollection 2016.
BACKGROUND
Intrathecal administration of baclofen by implanted pump reduces rigidity and muscle spasms. Its use specifically to control bladder spasms has not been reported.
CASE REPORT
A tetraplegic patient developed severe, protracted, bladder spasms, abdominal muscles spasms, and high blood pressure after change of suprapubic catheter; nifedipine, diazepam, and paracetamol did not control spasms; bolus dose of baclofen intrathecally produced prompt relief via baclofen pump.
CONCLUSION
Severe, protracted bladder spasms, abdominal muscles spasms, and autonomic dysreflexia, induced by change of suprapubic catheter in a spinal cord injury patient, were treated successfully by a bolus dose and increased total daily dose of intrathecal baclofen.
背景
通过植入泵鞘内注射巴氯芬可减轻僵硬和肌肉痉挛。其专门用于控制膀胱痉挛的情况尚未见报道。
病例报告
一名四肢瘫痪患者在耻骨上导尿管更换后出现严重、持续性膀胱痉挛、腹部肌肉痉挛和高血压；硝苯地平、地西泮和对乙酰氨基酚未能控制痉挛；鞘内注射大剂量巴氯芬通过巴氯芬泵迅速缓解症状。
结论
脊髓损伤患者因耻骨上导尿管更换引起的严重、持续性膀胱痉挛、腹部肌肉痉挛和自主神经反射异常，通过鞘内注射大剂量巴氯芬并增加每日总剂量得到成功治疗。
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