Dyck P
Spine (Phila Pa 1976). 1985 May;10(4):359-62.
A case report of inadvertent chymopapain introduction into the lumbar theca is reported. It led to an extensive subarachnoid and subdural hemorrhage, producing paraplegia. The neurotoxicity of chymopapain in the experimental model is reviewed and related to a clinical setting. Clinically speaking, there appears to be no tolerance for this discolytic agent either in the peripheral or central nervous system. Cerebrospinal fluid barbotage may lessen the neurologic injury by removing the enzyme when it finds its way inadvertently into the subarachnoid space.
本文报道了一例木瓜凝乳蛋白酶意外注入腰椎蛛网膜下腔的病例。这导致了广泛的蛛网膜下腔和硬膜下出血，进而引发截瘫。本文回顾了木瓜凝乳蛋白酶在实验模型中的神经毒性，并将其与临床情况相关联。从临床角度来看，无论是在外周神经系统还是中枢神经系统，似乎都无法耐受这种溶核剂。当木瓜凝乳蛋白酶意外进入蛛网膜下腔时，脑脊液冲洗或许可以通过清除该酶来减轻神经损伤。
