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目的掌握急性脊髓前动脉栓塞疾病的诊断与治疗。方法通过对我院1例急性脊髓前动脉栓塞疾病病例的诊疗过程、影像、实验室检验资料以及相关文献资料,进行回顾性分析和复习总结,掌握脊髓动脉栓塞疾病的临床特征,诊断手段及治疗方法。结果:急性脊髓前动脉栓塞病例少见,脊髓前动脉栓塞呈卒中样突然起病,剧烈根性疼痛,感觉平面以下分离性感觉障碍,截痪,二便障碍,自主神经功能障碍是主要临床特征。MRI平扫早期表现多为阴性,结合脊髓Flair/T2W及DWI高信号及脊髓MRI增强有低信号病灶者可做初步诊断,CTA、CE-MRA及血管造影发现相应平面脊髓动脉栓塞者,可以明确诊断。早期使用激素减轻脊髓水肿,改善预后。结论:出现上述临床特征,在排除其他神经脊髓病变以后,要进行MRI影像学检查明确是否有急性脊髓前动脉栓塞。早期使用激素可以有效的减轻脊髓水肿,改善预后。
Objective To master the diagnosis and treatment of acute anterior spinal artery embolism. Methods A retrospective analysis and review were made on the diagnosis and treatment of acute spinal cord embolism cases in our hospital. The clinical features, diagnostic methods and treatment of spinal cord arterial embolism method. Results: Acute spinal cord anterior embolism cases rare, anterior spinal cord embolism was a sudden onset of stroke, severe radical pain, sensory separation of the following sensory disorders, cut off, biceps, autonomic dysfunction is the main clinical features. Early manifestations of MRI were mostly negative, combined with spinal cord Flair / T2W and DWI high signal and spinal MRI enhanced low signal lesions can do a preliminary diagnosis, CTA, CE-MRA and angiography found that the corresponding planar spinal artery embolism, can be clear diagnosis. Early use of hormones to reduce spinal cord edema and improve prognosis. Conclusion: The above clinical features appear, in the exclusion of other neuropathies after spinal cord MRI imaging examination to determine whether there is an acute spinal cord embolization. Early use of hormones can effectively reduce spinal cord edema and improve prognosis.