自主血小板丰富的纤维素作为一种替代性外周贴片用于持续的持续性穿刺后头痛:单中心观察性研究
Ioannis Vasilikos1,2,3, Katerina Argiti1,2, Kevin Joseph1,2
1Department of Neurosurgery, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
富含血小板纤维素 (PRF) 的外周贴片提供了一个安全有效的替代方案,用于当传统的外周血贴片失败时,持续的腹腔穿孔后头痛 (PDPH). 这种新的方法显著减少疼痛和头痛症状,没有观察到任何不良影响.
科学领域:
- 麻醉学和疼痛管理
- 再生医学是一种再生医学.
- 神经外科 神经外科
背景情况:
- 腹膜外血贴片 (EBP) 是治疗腹膜后刺痛头痛 (PDPH) 的标准治疗方法.
- 在EBP后持续的PDPH需要替代治疗选择.
- 自主血小板丰富纤维素 (PRF) 呈现了一种用于外周周围补丁的新型治疗剂.
研究的目的:
- 评估外周 PRF 补丁 (EPP) 对于持久PDPH的安全性和有效性.
- 为了比较患者报告的EPP过程中的疼痛与EBP过程中的疼痛.
- 评估PDPH患者治疗EPP的长期症状减轻.
主要方法:
- 在多次EBP后,12名耐火性PDPH患者接受了外周PRF贴片 (EPP).
- 在光镜指导下,外周注射PRF.
- 患者报告的疼痛,头痛影响 (HIT-6) 和不良事件在术前和术后6个月内都受到监测.
主要成果:
- 在6个月的随访期间,EPP表现出良好的耐受性,没有观察到任何不良影响.
- 与EBP相比,与EPP手术相关的疼痛明显减少了52.8%.
- 6个月后,头痛冲击测试-6 (HIT-6) 的得分显示,PDPH症状在6个月后显著减少了33.3%.
结论:
- 外周 PRF 补丁 (EPP) 是一种可行且安全的替代方案,用于管理持续的PDPH.
- 与 epidural blood patch (EBP) 相比,EPP的过程性疼痛显著减少.
- 观察到长达6个月的持续临床改善,需要对PDPH的EPP进行进一步调查.
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