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作者报告二例碘葡酰胺脊髓造影后的不可逆性神经系统并发症。例1:因车祸而致 L_1骨折,曾行手术清除骨片,压迫症状一度消除,两年后双下肢运动、感觉、二便功能症状渐恶化,9年后再次住院检查,作碘葡酰胺(11ml)脊髓造影后一小时发生不可逆的急性(T_(11)以下)横贯性脊髓病。例2:20年前因腰椎间盘脱出行椎板切除。造影证明有蛛网膜炎,造影后几乎立即出现不可逆的多发性神经根病变。此二例对激素治疗皆无效。碘葡酰胺在170毫克碘/1毫升时与脑脊液等渗(造影时用220毫克碘/1毫升),2～6小时脑内达最高浓度,98%在3～4小时内从脑脊液中消失,但大脑皮层内浓度可持续24小时。碘葡酰胺可直接刺激神经组织,竞争阻抑已糖激酶,拮抗乙酰胆碱并抑制乙酰胆碱酯酶。碘葡酰胺脊髓造影的并发症大多数
The authors report two cases of irreversible neurological complications after iridoglossomyelography. Example 1: due to a car accident caused by L_1 fracture, had surgery to remove bone fragments, compression symptoms once eliminated, two years after the lower extremity movement, sensory, second defecation function symptoms gradually deteriorated, 9 years later hospitalized again for iodogluteramide 11ml) one hour after myelography irreversible acute (T_ (11) or less) transverse myelopathy. Example 2: Lumbar disc herniation 20 years ago. Radiographic evidence of arachnoiditis, almost irreversible radicular nerve root lesions occur immediately after contrast. The two cases of hormone therapy are ineffective. Iodoglutamide was isotonic with cerebrospinal fluid at 170 mg Iodine / 1 mL (maximum of 220 mg Iodine / 1 mL at 2 to 6 hours), 98% disappeared from cerebrospinal fluid within 3 to 4 hours, However, the concentration in the cerebral cortex can last 24 hours. Iodoglutamide directly stimulates nerve tissue, competes for inhibition of hexokinase, antagonizes acetylcholine and inhibits acetylcholinesterase. Iodisopramine most of the complications of myelography