Kobayashi Y, Shiotani M, Oseto K, Naganuma Y, Karasawa H, Ohno K
Department of Pain Clinic, Izu Teishin Hospital, Shizuoka.
Masui. 1993 Jun;42(6):888-97.
We treated six cases of epidural abscess caused probably by epidural block. Three patients were given only chemotherapy and the other three underwent surgical treatment. Four patients were cured completely, but bilateral paresis in the lower limbs persisted in two patients. The symptoms at onset, laboratory findings, imaging findings including MRI and CT, treatment methods and prognosis were reported. Accelerated blood sedimentation rate, positive CRP results and abnormal findings at the site of the catheter insertion appeared to be important initial signs for the early discovery of epidural abscesses. The route of infection, selection of treatment methods, methods of prevention and examination by Gadolinium-MRI imaging were also discussed.
我们治疗了6例可能由硬膜外阻滞引起的硬膜外脓肿病例。3例患者仅接受了化疗,另外3例接受了手术治疗。4例患者完全治愈,但2例患者双下肢麻痹持续存在。报告了发病时的症状、实验室检查结果、包括MRI和CT在内的影像学检查结果、治疗方法及预后。血沉加快、CRP结果呈阳性以及导管插入部位出现异常表现似乎是早期发现硬膜外脓肿的重要初始体征。还讨论了感染途径、治疗方法的选择、预防方法以及钆增强MRI成像检查。