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脊柱手术后有症状血肿的发生率及临床特征：45例患者的多中心研究

Incidence and Clinical Features of Postoperative Symptomatic Hematoma after Spine Surgery: A Multicenter Study of 45 Patients.

作者信息

Masuda Soichiro, Fujibayashi Shunsuke, Takemoto Mitsuru, Kim Youngwoo, Otsuki Bungo, Ota Masato, Soeda Tsunemitsu, Watanabe Kei, Sakamoto Takeshi, Tsubouchi Naoya, Matsuda Shuichi

机构信息

Department of Orthopedic Surgery, Japan Community Health Care Organization, Shimane, Japan.

Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan.

出版信息

Spine Surg Relat Res. 2019 Nov 1;4(2):130-134. doi: 10.22603/ssrr.2019-0080. eCollection 2020.

DOI:10.22603/ssrr.2019-0080
PMID:32405558
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7217683/
Abstract

INTRODUCTION

Symptomatic postoperative hematoma after spine surgery is a rare but serious complication. The objective of this study was to investigate the incidence and clinical features of symptomatic postoperative hematoma after spine surgery.

METHODS

We retrospectively identified 10,680 patients who underwent spine surgery between 2002 and 2012 in nine hospitals. We reviewed the incidence of postoperative hematoma and its clinical features, including time before onset, main symptoms, and neurological outcomes.

RESULTS

The overall incidence of symptomatic postoperative hematoma after spine surgery was 0.4% (45/10,680). Postoperative hematoma was more frequent after thoracic spine surgery than after cervical or lumbar surgery. The onset of postoperative hematoma occurred at an average of 2.6 days (range 0-14 days) postoperatively. The chief symptoms caused by postoperative hematoma after spine surgery were tetra/paraplegia in 30 patients, hemiplegia in eight patients, intractable pain in five patients, and airway dysfunction in two patients. Surgical evacuation of the spinal epidural hematoma resulted in improvement of at least one grade in 35 patients, while four patients had complete motor paralysis even after evacuation surgery.

CONCLUSIONS

We report the clinical details of 45 patients with postoperative hematoma after spine surgery. This information could assist surgeons to make a prompt diagnosis and perform early evacuation surgery for postoperative hematoma following spine surgery.

摘要

引言

脊柱手术后出现症状性术后血肿是一种罕见但严重的并发症。本研究的目的是调查脊柱手术后症状性术后血肿的发生率和临床特征。

方法

我们回顾性确定了2002年至2012年期间在九家医院接受脊柱手术的10680例患者。我们回顾了术后血肿的发生率及其临床特征，包括发病前时间、主要症状和神经学结果。

结果

脊柱手术后症状性术后血肿的总体发生率为0.4%（45/10680）。胸椎手术后术后血肿比颈椎或腰椎手术后更常见。术后血肿的发病平均发生在术后2.6天（范围0-14天）。脊柱手术后术后血肿引起的主要症状为30例患者出现四肢/截瘫，8例患者出现偏瘫，5例患者出现顽固性疼痛，2例患者出现气道功能障碍。手术清除脊髓硬膜外血肿使35例患者的神经功能至少改善一级，而4例患者即使在清除手术后仍有完全性运动麻痹。

结论

我们报告了45例脊柱手术后术后血肿患者的临床细节。这些信息有助于外科医生对脊柱手术后的术后血肿做出快速诊断并进行早期清除手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70e4/7217683/43b63377b7a7/2432-261X-4-0130-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70e4/7217683/43b63377b7a7/2432-261X-4-0130-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70e4/7217683/43b63377b7a7/2432-261X-4-0130-g001.jpg

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