棘突起の圧迫による硬膜外カテーテル切断の1例 A CASE OF ACCIDENTAL DISCONNECTION OF AN EPIDURAL CATHETER IN THE BODY

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抄録

腰椎棘突起の圧迫による硬膜外カテーテル体内切断の1例を報告した.症例は86歳,男性.変形性脊椎症による腰下肢痛に対して持続硬膜外ブロックを行った.カテーテル留置から26日目に,カテーテルは体内で切断し,先端側2.5cmは体内に遺残した.体外側カテーテルの切断端は押しつぶされ扁平であった.後日撮影したX線写真では,カテーテル刺入部の棘突起間は極めて狭く,体動により上下棘突起は容易に接した.遺残カテーテルはそのまま放置とし,遺残1年後現在,感染は神経根症状はない.<br> 本例のような棘突起の圧迫によるカテーテル切断の報告例は,本邦では2例に過ぎない.カテーテル挿入の際には,カテーテルが圧迫を受けないよう,挿入の部位や方法の選択に注意を要する.特に高齢者では予めX線写真などで棘突起の状態をよく観察すべきである.

The author reported a case of accidental disconnection of an epidural catheter due to oppression between lumbar spinal processes. An 86-year-old man with spondylosis deformans underwent epidural catheterization for control of a low back pain and lower extremity pain. On the 26th day after the catheterization, disconnection of the catheter was noticed. The head of the catheter, measuring 2.5cm in length, was remained in the body. Extracorporial end of the catheter was flatly pressed. After the accident X-ray films of the lumbar spine revealed very narrow space between the processes and easy contact of the processes by motion. The patient was not operated on to remove the remnant. As of one year after the trouble he is well free from local infection and nerve radiculopathy.<br> Disconnection of epidural catheter due to oppression is a rare entiry, and only two such cases have been reported in Japan. X-ray films of the spine should be taken before the insertion, especially in aged patients. They might contribute to choice the location and method for epidural catheterization in order to prevent from oppression.

収録刊行物

  • 日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society

    日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society 57(9), 2288-2290, 1996-09-25

    Japan Surgical Association

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各種コード

  • NII論文ID(NAID)
    10008524387
  • NII書誌ID(NCID)
    AN00198696
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    03869776
  • データ提供元
    CJP書誌  J-STAGE 
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