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腰椎穿刺导致腰动脉穿孔和低血压:一例报告。

Lumbar puncture resulting in lumbar artery perforation and hypotension: A case report.

作者信息

D'Angelo Anthony, Ghogomu Mbinui, Akhtar Zahra, Khan Hasan

机构信息

John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, USA.

Department of Radiology, The University of Texas Medical Branch, Galveston, TX, USA.

出版信息

Radiol Case Rep. 2025 May 16;20(8):3826-3831. doi: 10.1016/j.radcr.2025.04.016. eCollection 2025 Aug.

Abstract

Lumbar puncture (LP) is a very common procedure that can rarely lead to complications such as headache or spinal hematoma. This report presents the case of a 59-year-old female who underwent LP and subsequently developed a retroperitoneal hematoma leading to hemorrhagic shock, requiring emergent embolization by interventional radiology. Life-threatening bleeding is a very rare complication of LP but should be kept in mind especially for patients with large body habitus who undergo multiple unsuccessful bedside attempts. In this case, the LP needle missed the spinal canal and pierced the L4 lumbar artery. We present this case to uncover potential factors that may have contributed to the development of such hemorrhage and to elaborate the steps of care to control such devastating hemorrhage.

摘要

腰椎穿刺(LP)是一种非常常见的操作,但很少会导致诸如头痛或脊髓血肿等并发症。本报告介绍了一名59岁女性的病例,该患者接受了腰椎穿刺,随后发生了腹膜后血肿,导致出血性休克,需要介入放射科进行紧急栓塞治疗。危及生命的出血是腰椎穿刺极为罕见的并发症,但应予以重视,尤其是对于体型较大且多次床边穿刺未成功的患者。在本病例中,腰椎穿刺针未进入椎管,而是刺破了腰4动脉。我们呈现此病例,以揭示可能导致此类出血发生的潜在因素,并阐述控制这种严重出血的护理步骤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e076/12143774/4ab50a0f8bda/gr1.jpg

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