摘要
目的讨脊髓硬膜外脓肿（SEA）的临床特点。方法回顾性分析我国1979-2014年期间在CNKI医学数据库公开发表的临床资料完整的47例SEA患者的病史、微生物检查、影像学检查及治疗方法、预后。结果47例患者中，男32例，女15例；年龄5-81岁，平均（33．8±20．3）岁；临床表现为疼痛45例（95．7％1、发热41例（87．2％）、肌力下降39例（83．0％）；受累脊柱为颈椎8例（17．0％）、胸椎31例（66．0％）、腰椎23例（48．9％）、骶椎2例（4.3％）；血培养6例（12．8％），其中阳性4例，3例为金黄色葡萄球菌，1例为链球菌；脓液检查42例（89．4％），其中脓液涂片10例，均为革兰氏阳性菌，而脓液培养32例（阳性26例），最常见为金黄色葡萄球菌（20例）；手术治疗45例（95．7％），保守治疗2例（4.3％1；经治疗肌力改善30例（63．8％），肌力持平11例（23．4％），恶化3例（6．4％），记录不详3例（6．4％）。结论SEA最易累及胸椎，其次为腰椎、颈椎和骶椎；首要致病菌为金黄色葡萄球菌：早期脊柱CT或MRI检查有助于SEA的诊断。
Objective To study the clinical manifestations in patients with spinal epidural abscess （SEA）. Methods The medical history, microorganism, image, treatment and prognosis of 47 cases of SEA with integrated clinical data published in CNKI were reviewed from 1979 to 2014 in China. Results Males were 32 and female were 15 in 47 cases. The age ranged from 5 to 81 years with mean of （33.8±20.3） years. The clinical manifestations included pain （95.7%, 45/47）, fever （87.2%, 41/47） and weakened strength of muscle （83.0%, 39/47）; the vulnerable spine involved cervix （17.0%, 8/47）, thorax （66.0%, 31/47）, lumbar （48.9%, 23/47） and sacrum （4.3%, 2/47）. Blood culture was performed in 6 cases （12.8%）, and 4 of them were positive, including three of staphylococcus aureus and one of streptococcus. Surgical treatment was given to 45 cases （95.7%） and conservative treatment to two cases （4.3%）; improvement of myodynamia was noted in 30 patients （63.8%）, no improvement in 11 patients （23.4%）, deteriorative myodynamia in three cases （6.4%） and three of them （6.4%） without detail record. Conclusions SEA was a infectious disease liable to involved easily thoracic vertebra, then lumbar vertebra, cervical vertebra and sacrum. Staphylococcus aureus was mainly pathogenic bacteria in SEA. Spinal CT or MRI examination in the early stage of SEA can influence prognosis.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2016年第2期193-195,共3页
Chinese Journal of Neuromedicine
关键词
硬膜外脓肿
脊髓
临床特点
Epidural abscess
Spine
Clinical analysis
