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作者报告一例病人腰麻后出现急性单侧听觉丧失,经硬膜外自体血液充填治愈。病人,女,27岁。身体素健。查体和实验室检查均无异常,在腰麻下行剖腹取胎术。先静滴乳酸盐林格氏液1,500ml,然后用25G针腰穿注入10％葡萄糖液配制的丁卡因8mg。术中输乳酸盐林格氏液1,000ml,麻醉平稳,手术顺利。术中失血约600ml。腰麻后4小时感觉完全恢复。术后第2天,出现左耳听力完全丧失,与体位有关。经卧床休息,补液及心理上的保证和安慰不见效,4天后听力仍未恢复并伴有眩晕、恶心。在床旁做听力试验提示低频范围内传导性听力损害。即在原腰穿部位作硬膜外穿刺并注入自体血10ml。片刻后听觉即有改善,1小时后听力恢复正常。术后7天出院。 Vandam等报道腰麻后并发听力损害的发生率为0.4％,包括听力减退、耳闭、阻塞感、耳鸣、嗡嗡声、跳动声或爆裂音等,并且多与体位有关。有人认为这种听觉症状可能是继发于腰穿后脑脊液压力降低。解剖学方面,耳蜗经耳蜗管与蛛网膜下腔相通。外淋巴(Perilymph)填满耳蜗的外淋
The authors report an acute unilateral hearing loss in a patient with spinal anesthesia and healed by epidural autologous blood. Patient, female, 27 years old. Body Su Jian. Physical examination and laboratory tests were normal, underwent cesarean section in the spinal anesthesia. First intravenous lactate Ringer’s solution 1,500 ml, and then use 25G acupuncture injection of 10% glucose solution of tetracaine formulated 8mg. Intraoperative lactate Ringer’s solution 1,000ml, anesthesia smooth, smooth operation. Intraoperative blood loss of about 600ml. Spinal 4 hours after feeling completely restored. On the 2nd postoperative day, there was a complete loss of left ear hearing, which was related to the position. After bed rest, fluid replacement and psychological assurance and comfort are not effective, 4 days after the hearing has not recovered and accompanied by dizziness, nausea. Hearing tests at the bed suggest conductive hearing loss in the low frequency range. In the original lumbar puncture site for epidural puncture and injection of autologous blood 10ml. After a while hearing has improved, 1 hour after hearing returned to normal. Seven days after discharge. Vandam et al. Reported that the incidence of concurrent hearing loss after spinal anesthesia was 0.4%, including hearing loss, ear closure, obstruction, tinnitus, buzz, beep or crackle, and more related to the position. Some people think that this auditory symptom may be secondary to lower cerebrospinal fluid pressure after lumbar puncture. Anatomy, the cochlear cochlear and subarachnoid communicating. Perilymph Cochlear implants