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肾上腺区腹主动脉瘤开放修复术后截瘫

Paraplegia after Open Repair of Suprarenal Abdominal Aortic Aneurysm.

作者信息

Kim Hyo Jun, Park Hyung Sub, Shin Chang Sik, Cho Jae S, Lee Taeseung

机构信息

Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.

Department of Surgery, Case Western Reserve University, Cleveland, OH, USA.

出版信息

Vasc Specialist Int. 2020 Dec 31;36(4):248-251. doi: 10.5758/vsi.200078.

Abstract

Spinal cord ischemia after open repair of abdominal aortic aneurysm (AAA) is an unpredictable and devastating complication. We present a case report of a patient who developed paraplegia 6 hours after open repair of suprarenal AAA. A 74-yearold man presented with asymptomatic 5.5-cm suprarenal AAA, for which he underwent open repair under general anesthesia. The paraplegia was identified 6 hours after the operation. Postoperative magnetic resonance imaging showed T2 signal hyperintensity and swelling of the spinal cord, which were consistent findings with subacute spinal cord infarction. Although intravenous steroid was administered and lumbar cerebral spinal fluid drainage was instituted, his neurological outcome did not improve. He was discharged after vigorous rehabilitation but still has paraplegia and requires wheelchair for ambulation.

摘要

腹主动脉瘤(AAA)开放修复术后脊髓缺血是一种不可预测的毁灭性并发症。我们报告一例患者,其在肾上腺AAA开放修复术后6小时出现截瘫。一名74岁男性因无症状的5.5厘米肾上腺AAA就诊,在全身麻醉下接受了开放修复手术。术后6小时发现截瘫。术后磁共振成像显示脊髓T2信号高增强和肿胀,这与亚急性脊髓梗死的表现一致。尽管给予了静脉类固醇治疗并进行了腰椎脑脊液引流,但他的神经功能并未改善。经过积极康复后他出院了,但仍有截瘫,行走需要轮椅。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e153/7790699/d2a260f31fef/VSI-36-248-f1.jpg

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