Linnemann M U, Bülow H H
Anaestesiologisk afdeling R, Bispebjerg Hospital, København.
Ugeskr Laeger. 1993 Jul 26;155(30):2350-2.
Three cases of iatrogenic infection following the insertion and subsequent use of an epidural catheter are described. The development, symptoms, diagnostic possibilities and treatment of epidural abscess are described. It is stressed that patients with decreased immunological defences are more prone to infection. Two patients with epidural abscesses are described. In both cases there was a "doctors-delay" before diagnosis was reached. Despite neurosurgical intervention both patients developed paralysis of the lower extremities, bladder and intestinal function, in one of them irreversibly. We also describe one patient who developed meningitis following eight attempts to insert an epidural catheter. The importance of quick diagnosis and intervention is stressed as well as the importance of strict sterility while inserting and using epidural catheters.
本文描述了3例硬膜外导管置入及后续使用后发生医源性感染的病例。阐述了硬膜外脓肿的发生、症状、诊断方法及治疗。强调免疫防御功能降低的患者更容易发生感染。描述了2例硬膜外脓肿患者。在这两例中，诊断前均存在“医生延误”情况。尽管进行了神经外科干预，但两名患者均出现了下肢、膀胱和肠道功能麻痹，其中1例为不可逆性麻痹。我们还描述了1例在硬膜外导管置入8次尝试后发生脑膜炎的患者。强调了快速诊断和干预的重要性，以及在硬膜外导管置入和使用过程中严格无菌操作的重要性。
