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관동맥 중재술 후 항혈소판제 병합복용 중 발생한 자발성 척추 경막외 혈종

Spontaneous Spinal Epidural Hematoma Caused by Dual Antiplatelet Agent Therapy after Percutaneous Coronary Intervention

  • 김선우 (한림대학교 의과대학 내과학교실) ;
  • 유하나 (한림대학교 의과대학 내과학교실) ;
  • 송영진 (한림대학교 의과대학 내과학교실) ;
  • 한동희 (한림대학교 의과대학 내과학교실) ;
  • 김지현 (한림대학교 의과대학 내과학교실) ;
  • 최은정 (한림대학교 의과대학 내과학교실) ;
  • 이남호 (한림대학교 의과대학 내과학교실)
  • Kim, Sun Woo (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Yoo, Hana (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Song, Young Jin (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Han, Dong Hee (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Kim, Ji Hyun (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Choi, Eun Jeong (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Lee, Namho (Department of Internal Medicine, Hallym University College of Medicine)
  • 투고 : 2012.07.11
  • 심사 : 2012.08.13
  • 발행 : 2013.05.01

초록

자발성 척추 경막외 혈종은 비교적 드문 질환으로, 명백한 외상의 증거가 없고 척추천자나 수술 등의 의인성 합병증 없이 발생하는 경우를 말하며 주로 혈액 응고 이상 질환이나 항혈전제 사용, 혈관기형 및 종양에 의해 발생한다. 임상양상은 갑작스런 목 또는 허리의 통증이 발생하고 병변의 위치에 따라 사지 마비 혹은 하반신 마비로 진행될 수 있어 즉각적인 추궁판 절제술 및 감압술이 필요한 것으로 알려져 있다. 저자들은 관상동맥 스텐트 삽입술 후 아스피린과 클로피도그렐 병합복용 중 발생한 척추 경막외 혈종을 경험하였기에 보고하는 바이다.

Spontaneous spinal epidural hematomas (SSEH) are rare, accounting for less than 1% of all spinal epidural lesions. The potential causes include coagulopathies, antithrombotic drugs, hypertension, increased venous pressure, and vascular malformations. A SSEH causes severe neurological deficits unless treated in a timely manner. As the number of patients who are diagnosed with ischemic heart disease and treated using percutaneous coronary intervention (PCI) increases, the prescription of dual antiplatelet agents is also increasing. We report a case of SSEH caused by dual antiplatelet agent therapy in a patient who had undergone PCI.

키워드

참고문헌

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