Morichika S, Shima M, Imanaka Y, Nakajima M, Iwasaki S, Yoshioka A
Department of Pediatrics, Nara Medical University.
Rinsho Ketsueki. 1995 Jul;36(7):687-93.
Case 1: Sensory and motor paralysis below the L3 level developed in a moderate hemophilia A due to spinal epidural bleeding following lumbar anesthesia for the resection of retro-peritoneal hematoma. By the treatment with cryoprecipitates, the patient recovered to walk with sticks after laminectomy. Case 2: the patient had severe hemophilia A with 220 Bethesda units/ml of inhibitor. The patient suffered from epidural and intramedullary spinal bleeding from C3 to C7 and developed tetraplegia. Since the inhibitor titer was high, infusion therapy with FEIBA was performed. Paralysis gradually reduced to the T5 level, but the patient had both sensory and motor paralysis of the extremities. It is required that an effective hemostastic treatment for spinal canal bleeding in hemophilia A with high-responder inhibitor is established.
病例1:一名中度甲型血友病患者,在因切除腹膜后血肿行腰椎麻醉后发生脊髓硬膜外出血,导致L3水平以下感觉和运动麻痹。经冷沉淀治疗后,患者在椎板切除术后恢复到拄拐行走。病例2:患者患有严重甲型血友病,抑制剂水平为220贝塞斯达单位/毫升。患者发生了从C3至C7的硬膜外和脊髓内出血,并发展为四肢瘫痪。由于抑制剂滴度较高,遂进行了FEIBA输注治疗。麻痹逐渐减轻至T5水平,但患者仍有四肢的感觉和运动麻痹。需要建立一种针对具有高反应性抑制剂的甲型血友病患者椎管出血的有效止血治疗方法。