硬膜穿破后头痛

摘要/Abstract

摘要： 硬膜穿破后头痛是脑膜穿破后的常见病发症。 1898年 Karl August Bier 报道了第一列硬膜穿破后头疼。Bier认为这与硬脊膜穿破后脑脊液持续渗漏有关。本文介绍了PDPH的机制，危险因素，诊断和治疗方式。特殊设计的针尖形状不损伤硬脊膜，减少脑脊液流失，术后头疼发生率明显减少。血补片是较常用且有效的治疗硬膜穿刺后头痛方法。

关键词: 硬膜穿破后头痛, 脑脊液, 穿刺针, 血补片

Abstract: Spinal anesthesia was first developed in the late 1800s by Wynter, Quincke and Corning. However, a German surgeon, Karl August Bier, in 1898 gave the first spinal anesthesia. Bier, himself experience the severe headache due to dural puncture. He suspected that the headache was due to excessive loss of cerebrospinal fluid (CSF). Recently, there have been lots of modification in the size and tip of spinal needles which lead to decrease the incidence of Post dural puncture headache (PDPH). There are various major of management for PDPH such as conservative, pharmacological and interventional management. Epidural blood patch has the highest cure rate. There are other various majors such as epidural saline, epidural dextran, opiods, fibrin glues had been used to reduce the incidence of PDPH. The surgical closure of the dura mater is the last resort in the management of PDPH.

Key words: post dural puncture headache, cerebrospinal fluid, spinal needles, Epidural blood patch

Eroj Manandhar 张晓庆. 硬膜穿破后头痛[J]. 外科研究与新技术, 2016, 5(2): 126-131.

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