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病例报告:越南产科硬膜外麻醉后硬膜外脓肿

Case Report: Epidural Abscess Following Obstetric Epidural Anesthesia in Vietnam.

作者信息

Nguyen Lam Duc, Vo Toan Thanh, Tran Cuong Van, Hoang Tam Thi-Thanh, Vu Phuoc Xuan, To Kha Dong, Doan Ha Thi-Ngoc, Nguyen Anh Duy

机构信息

Hanoi Medical University, Hanoi, Vietnam.

Thong Nhat Hospital, Ho Chi Minh City, Vietnam.

出版信息

Int Med Case Rep J. 2021 May 12;14:301-305. doi: 10.2147/IMCRJ.S301536. eCollection 2021.

Abstract

Epidural abscess after obstetric epidural anesthesia occurs infrequently and may result in severe morbidity. We report a clinical case of an epidural abscess in Vietnam. A 31-year-old woman who was in labor was admitted to our hospital and given epidural anesthesia indicated to relieve labor pain. After three hours of anesthesia, cesarean section was indicated for the patient due to signs of fetal failure, the epidural catheter was then used to relieve pain for the first 48 hours postoperatively. On post-partum day 5 she presented with high fever of 39-40°C, fatigue, stimulation, dyspnea, and lumbar pain. The patient then suffered from sepsis and lower limb paralysis. She was diagnosed with epidural abscess based on the MRI of the lumbar spine. The abscess was treated by surgery for draining and appropriate antibiotics with a satisfactory outcome as she completely recovered her motor function and stable health status.

摘要

产科硬膜外麻醉后硬膜外脓肿很少发生,可能导致严重的发病情况。我们报告越南一例硬膜外脓肿的临床病例。一名31岁的产妇入院并接受硬膜外麻醉以缓解分娩疼痛。麻醉三小时后,因胎儿窘迫迹象对患者实施剖宫产,术后前48小时使用硬膜外导管缓解疼痛。产后第5天,她出现39 - 40°C的高热、乏力、激惹、呼吸困难和腰痛。该患者随后发生败血症和下肢瘫痪。根据腰椎MRI诊断为硬膜外脓肿。通过手术引流脓肿并给予适当抗生素治疗,结果令人满意,因为她完全恢复了运动功能且健康状况稳定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4936/8128129/76467afc4b95/IMCRJ-14-301-g0001.jpg

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