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帝王切開術後に静脈血栓塞栓症に対する予防的抗凝固療法としてエノキサパリンナトリウムを投与した患者が,腰部硬膜外血腫を発症し急速な下肢筋力低下と排尿障害を来したので報告する.投薬の中止,椎弓切除・血腫除去術により,肛門周囲に軽度のしびれを残すものの筋力低下・排尿障害は軽快した.抗凝固療法を行う際は,患者背景や硬膜外麻酔との併用に十分注意を払わなければならない.
We report the case of a patient who developed a lumbar epidural hematoma and experienced lower extremity weakness and dysuria after administration of enoxaparin sodium as anticoagulant therapy to prevent venous thromboembolism after a cesarean section. The patient's symptoms were improved by discontinuation of the medication, laminectomy, and removal of the hematoma, except for mild perianal numbness. Attention to patient's background and its relation to epidural anesthesia is necessary before performing anticoagulant therapy.
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