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患者男性,46岁.因腰腿痛伴间歇性跛行2年多收住院,行椎管造影检查.取头高15°、左侧卧位,L_(3、4)间隙穿刺,放出脑依液5ml,往入造影剂5ml.注药时间持续1分钟.造影过程顺利,摄片显影好.造影结束后病人坐位返病房,1小时后感双下肢肌肉剧痛,穿刺平面以下肌肉阵发性抽搐.开始每间隔1～2分钟抽搐一次,每次1～2秒,以后间隔缩短至4～5秒.抽搐每次持续10秒以上.病人极痛苦.大汗淋漓,脉搏160/分.呼吸38次/分,血压180/100mmHg.确诊为椎管内误注入泛影葡胺所致(本应注入碘苯酯).先给予注射安定、鲁米那钠无效,以后予硫苯妥钠250mg静注后抽搐停止.1个小时后又强烈抽搐2次.分别再静注硫苯妥钠125mg2次后症状逐渐减轻.治疗3日抽搐完全停止出院.随访无后遗症,3个月再住院行腰椎间盘摘除.
Male patient, 46 years old .Because of low back pain with intermittent claudication more than 2 years admitted to hospital, line of spinal canal angiography .Take the head high 15 °, left lateral decubitus, L_ (3,4) 5ml, into the contrast agent 5ml. Injection time lasted 1 minute. Imaging process smoothly, good radiography .After the end of contrast the patient sit back to the ward, 1 hour after feeling both leg muscle pain, puncture muscle below paroxysmal convulsions .At the beginning of every 1 to 2 minutes of convulsions, 1 to 2 seconds each time, after the interval shortened to 4 to 5 seconds.Every time lasts more than 10 seconds.Patients extremely painful. Sweating, pulse 160 / min. Breathing 38 Times / min, blood pressure 180 / 100mmHg. Was diagnosed as misdiagnosis of intramedullary diatrizoate (which should be injected iodine ester.) First given injection stability, luminal sodium invalid, later to the safety of sodium thio-250mg Note convulsions stopped .1 hours after a strong convulsions 2 times respectively intravenous injection of sodium thiamine 125mg2 times symptoms gradually reduced .Treatment of convulsions completely stopped discharged .Seven sequelae were followed up for 3 months and then hospitalized lumbar intervertebral disc Removal.