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产科硬脊膜穿剌后头痛的治疗。第 2 部分:硬膜外血贴。

Treatment of obstetric post-dural puncture headache. Part 2: epidural blood patch.

机构信息

Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

Department of Anaesthetics, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.

出版信息

Int J Obstet Anesth. 2019 May;38:104-118. doi: 10.1016/j.ijoa.2018.12.005. Epub 2018 Dec 22.

Abstract

The 2009-12 MBRRACE-UK report highlighted the deaths of two women in whom dural puncture had occurred during insertion of a labour epidural catheter. Despite suffering long-term headaches, neither woman was adequately followed-up after discharge from hospital. Death resulted from a cerebral vein thrombosis in one case and a subdural haematoma in the other. Due to significant variation in the treatment of obstetric post-dural puncture headache, an Obstetric Anaesthetists' Association working group was set up to produce evidence-based guidelines to guide clinicians. These guidelines have been condensed into two review articles. In this second review, the role of an epidural blood patch is discussed using a question and answer format.

摘要

2009-12 年 MBRRACE-UK 报告强调了两名在分娩硬膜外导管插入过程中发生硬脑膜穿刺的女性的死亡。尽管这两名女性都长期头痛,但在出院后都没有得到充分的随访。其中一名死于脑静脉血栓形成,另一名死于硬脑膜下血肿。由于产科硬脑膜穿刺后头痛的治疗方法存在显著差异,因此成立了一个产科麻醉师协会工作组,以制定循证指南来指导临床医生。这些指南已经被浓缩为两篇综述文章。在第二篇综述中,采用问答形式讨论了硬膜外血贴的作用。

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