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目的通常的硬膜外自体静脉血补片疗法操作过程复杂,危险性很高,且不能完全开展,本研究采用非靶向硬膜外自体静脉血补片疗法治疗低颅压头痛,对该方法的治疗机制及应用价值等方面进行讨论报告,并对非靶向硬膜外血贴的治疗机制和应用价值等进行讨论。方法 6例自发性颅内低压患者(男性2例,女性4例,年龄44~70岁),符合2004年国际头痛分类第2版诊断标准,采用非靶向硬膜外自体静脉血补片疗法治疗,选择在腰椎1~2水平椎间隙进行穿刺,行硬膜外置管,将新鲜自体静脉血迅速通过硬膜外置管缓慢注入硬膜外间隙,并对所有患者进行随诊。结果 6例患者经非靶向硬膜外自体静脉血补片治疗后均痊愈。其中有4例患者治疗1次后痊愈,1例患者治疗2次后痊愈,1例患者在原注射治疗处的下一椎间隙处行硬膜外自体静脉血补片治疗,头痛症状仍未得到完全缓解,后又在相同位置进行2次硬膜外自体静脉血补片疗法治疗,术后观察3~9个月均无复发。结论非靶向硬膜外自体静脉血补片疗法是一种安全、有效的自发性颅内低压治疗手段,该方法不仅操作简单,而且危险性小且无需影像学漏点定位,亦有不错的治疗效果,因此可得到较好的开展。
Purpose The routine epidural autologous venous blood patch therapy is complicated and dangerous, and can not be fully developed. In this study, non-targeted epidural venous blood patch therapy was used to treat patients with low intracranial pressure headache. The treatment mechanism and the value of such aspects of the discussion report, and non-targeted epidural plaster treatment mechanism and application value are discussed. Methods Six patients with idiopathic intracranial hypertension (2 males and 4 females, aged 44-70 years) were enrolled in the International Diagnostic Classification of Headache Category 2 (2004). Non-targeted epidural venous blood patch therapy Treatment, select the lumbar level 1 ~ 2 intervertebral space for puncture, epidural catheter, the fresh autologous venous blood was slowly injected into the epidural space through the epidural catheter, and all patients were followed up. Results Six patients were cured by non-targeted epidural autologous venous blood. Among them, 4 patients recovered after 1 treatment, 1 patient recovered after 2 treatments, 1 patient underwent epidural autologous venous blood patch at the next intervertebral space of the original injection treatment, and the headache symptom was still not completely Ease, and then in the same location 2 times epidural venous autologous blood patch therapy, postoperative observation of 3 to 9 months were no recurrence. Conclusion Non-targeted epidural venous blood patch therapy is a safe and effective means of treatment of idiopathic intracranial hypopnea. This method not only has the advantages of simple operation, low risk and no need to locate missed images, but also has good Therapeutic effect, so get a better start.