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在意外硬膜外注射2%氯己定酒精溶液后发生粘连性蛛网膜炎——在随后八年中部分恢复。

Adhesive arachnoiditis following inadvertent epidural injection of 2% chlorhexidine in 70% alcohol-partial recovery over the ensuing eight years.

作者信息

Mohamed Iqbal I, Morris R, Hersch M

机构信息

Staff Specialist, Department of Anaesthesia, St George Hospital; Conjoint Clinical Lecturer, St George and Sutherland Clinical School, University of New South Wales; Sydney, New South Wales.

Conjoint Associate Professor, St George and Sutherland Clinical School, University of New South Wales; Sydney, New South Wales.

出版信息

Anaesth Intensive Care. 2018 Nov;46(6):572-574. doi: 10.1177/0310057X1804600606.

Abstract

We report a case of serious neurologic injury due to inadvertent epidural injection of 8 ml of the antiseptic 2% chlorhexidine in 70% alcohol during a procedure aimed to relieve the pain of labour. This resulted in immediate severe back pain, progressive tetraparesis and sphincter dysfunction caused by damage to the spinal cord and nerve roots. Subacute hydrocephalus necessitated drainage, but cranial nerve and cognitive function were spared. Magnetic resonance imaging documented marked abnormality of the spinal cord and surrounding leptomeninges. In the ensuing eight years, there has been clinical and electrophysiological evidence of partial recovery, but neurologic deficit remains severe.

摘要

我们报告了一例在旨在缓解分娩疼痛的操作过程中,因意外硬膜外注射8毫升2%洗必泰酒精溶液导致严重神经损伤的病例。这导致了立即出现的严重背痛、进行性四肢轻瘫以及因脊髓和神经根损伤引起的括约肌功能障碍。亚急性脑积水需要进行引流,但颅神经和认知功能未受影响。磁共振成像显示脊髓和软脑膜明显异常。在随后的八年里,有临床和电生理证据表明有部分恢复,但神经功能缺损仍然严重。

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