本文選題：可逆性后部腦病綜合征 + 妊娠�。� 參考：《實(shí)用婦產(chǎn)科雜志》2015年08期

【摘要】：目的:探討妊娠合并可逆性后部腦病綜合征(PRES)的臨床及影像學(xué)特點(diǎn)、治療及預(yù)后,提高診療水平。方法:回顧性分析6例妊娠合并PRES患者的臨床資料,分析其臨床表現(xiàn)、影像學(xué)特點(diǎn)、治療過程及預(yù)后。結(jié)果:6例患者中有5例子癇或子癇前期(其中4例發(fā)生于產(chǎn)前,1例發(fā)生于產(chǎn)后),1例為地諾前列酮(普貝生)引產(chǎn)時(shí)發(fā)生子癇。均為急性起病,臨床表現(xiàn)主要為突發(fā)頭痛、抽搐、視覺障礙、意識(shí)障礙等。顱腦CT或MRI提示大腦后部雙側(cè)對(duì)稱、多灶性分布,累及頂枕葉為主的皮質(zhì)、皮質(zhì)下病灶。CT病灶呈低密度,典型的MRI檢查T1WI呈低信號(hào),T2WI及FLAIR高信號(hào)。所有患者發(fā)病后均給于硫酸鎂沖擊量加維持量解痙;4例靜脈泵入亞寧定(鹽酸烏拉地爾注射液)或佩爾地平降壓,2例口服降壓藥;所有患者均給予甘露醇或甘油果糖靜脈滴注降顱壓治療,其他治療還有糾正酸堿平衡紊亂、對(duì)癥支持等治療。所有患者經(jīng)積極治療,均未遺留后遺癥,發(fā)病到治愈出院時(shí)間7~11天。結(jié)論:妊娠合并PRES常見于子癇及子癇前期患者,顱腦MRI是診斷本病的重要檢查手段。對(duì)該病應(yīng)提高認(rèn)識(shí),及早發(fā)現(xiàn)及時(shí)治療,病情可逆轉(zhuǎn),預(yù)后良好。
[Abstract]:Objective: to investigate the clinical and imaging features, treatment and prognosis of pregnancy with reversible posterior encephalopathy syndrome (Pres), and to improve the diagnosis and treatment level. Methods: the clinical data, clinical manifestations, imaging features, treatment process and prognosis of 6 cases of pregnancy complicated with PRES were analyzed retrospectively. Results there were 5 cases of eclampsia or preeclampsia in 6 cases (4 cases occurred before and 1 case occurred in postpartum and 1 case was induced by prostaglandone). The clinical manifestations were sudden headache, convulsion, visual disturbance, consciousness disorder and so on. Craniocerebral CT or MRI showed bilateral symmetry, multi-focal distribution, mainly parietal occipital cortex, hypodensity of subcortical focus. Typical MRI showed low signal intensity on T _ 2WI and FLAIR. All the patients were treated with magnesium sulfate shock volume plus maintenance volume, 4 cases received intravenous injection of anindine (urapidil hydrochloride injection) or 2 cases of perdipine antihypertensive drug. All patients were treated with mannitol or fructose intravenous drip to reduce intracranial pressure. After active treatment, all patients had no sequelae and the time from onset to cure was 711 days. Conclusion: pregnancy with PRES is common in patients with eclampsia and preeclampsia. Craniocerebral MRI is an important diagnostic method for this disease. Understanding of the disease should be improved, early detection and timely treatment, the disease can be reversed, the prognosis is good.
【作者單位】： 北京大學(xué)人民醫(yī)院;
【分類號(hào)】：R714.25;R742

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本文編號(hào)：1872084