临床外科杂志 ›› 2022, Vol. 30 ›› Issue (3): 269-271.doi: 10.3969/j.issn.1005-6483.2022.03.019

• 论著 • 上一篇    下一篇

颈椎术后早期硬膜外血肿并发食管漏两次修补一例

  

  1. 430030 武汉,华中科技大学同济医学院附属武汉中西医结合医院脊柱外科(陈永杰);武汉市第一医院脊柱外科(刘伟、陶鹏飞、冯晶、夏平)
  • 收稿日期:2021-05-15 接受日期:2021-05-15 出版日期:2022-03-20 发布日期:2022-03-20
  • 通讯作者: 夏平,Email:xiapingfm@126.com

Acute cervical epidural hematoma and esophageal perforation after cervical spinal surgery:report of a case and review of the Literature

  • Received:2021-05-15 Accepted:2021-05-15 Online:2022-03-20 Published:2022-03-20

摘要: 目的 报道并分析颈椎术后出现多种并发症1例,为临床治疗提供经验。 方法 我院2017年收治颈椎病1例,行颈椎前路椎体次全切减压植骨融合术(ACCF),术后并发硬膜外血肿和食管漏,经急诊清除血肿、二次修补后痊愈,回顾分析术后硬膜外血肿及食管漏发生原因、临床表现、诊疗及预防。 结果 早期硬膜外血肿应及时手术清除,避免出现严重神经功能障碍;食管漏多表现为吞咽困难,若不能及时发现,将导致严重后果,食管漏的手术修补大多不可避免,手术治疗是取得良好效果的最终途径。 结论 颈椎术后多种并发症少见,加强围手术期管理,预防并发症发生是关键,早发现,早诊断,早治疗,避免危险因素,对手术预后有重要意义。

关键词:  颈椎术后, 并发症, 硬膜外血肿, 食管漏

Abstract: Objective We reported and analyzed a case with multiple complications after cervical spine surgery to provide some experience for clinical front-line workers. Methods To retrospectively analyze a patient with cervical spondylosis admitted to Wuhan First Hospital in 2017,who underwent anterior cervical subtotal vertebral decompression and implant fusion (ACCF).Epidural hematoma and esophageal fistula occurred after surgery,which healed after emergency surgery and two repairs.The causes,clinical manifestations,treatment and prevention of postoperative epidural hematoma and esophageal fistula were analyzed through literature review. Results Early epidural hematoma should be surgically removed in time to avoid serious neurological dysfunction;esophageal fistula mostly manifests as dysphagia,it will lead to serious consequences if not detected in time.Surgical repair of esophageal fistula is mostly unavoidable,which is the way to achieve good results. Conclusion Multiple postoperative complications after cervical spine are rare.Strengthening perioperative management and preventing complications are important for patients.Early detection,diagnosis and treatment will avoid risk factors,which are great significance for the quality of surgery and the prognosis of patients.

Key words: cervical spinal surgery;complication, epidural hematoma, esophageal perforation

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