CAJ | 학술논문

目的探讨围生期可逆性大脑后部白质脑病综合征的临床特征与护理要点.方法回顾性分析35例围生期可逆性大脑后部白质脑病综合征患者的临床特征、治疗、护理要点及预后.结果所有患者均急性起病,22.9％产前发病,77.1％产后发病.主要表现为头痛(65.7％)、抽搐(62.9％)、视觉异常(54.3％),意识障碍(22.9％),影像表现为双侧对称性可逆性以大脑后部皮质下白质为主的病变,包括枕叶(77.1％)、顶叶(65.7％)、颞叶(28.6％)、额叶(20.0％)等.MR弥散成像显示血管源性脑水肿.经过积极治疗控制血压和癫痫及临床特殊护理,所有患者的临床症状和影像改变在1d～2个月内明显改善或消退.结论提高对围生期可逆性大脑后部白质脑病综合征的认识,合理地应用护理程序提高护理质量是治疗成功的保证.
목적 탐토위생기가역성대뇌후부백질뇌병종합정적림상특정여호리요점.방법 회고성분석35례위생기가역성대뇌후부백질뇌병종합정환자적림상특정、치료、호리요점급예후.결과 소유환자균급성기병,22.9％산전발병,77.1％산후발병.주요표현위두통(65.7％)、추휵(62.9％)、시각이상(54.3％),의식장애(22.9％),영상표현위쌍측대칭성가역성이대뇌후부피질하백질위주적병변,포괄침협(77.1％)、정협(65.7％)、섭협(28.6％)、액협(20.0％)등.MR미산성상현시혈관원성뇌수종.경과적겁치료공제혈압화전간급림상특수호리,소유환자적림상증상화영상개변재1d～2개월내명현개선혹소퇴.결론 제고대위생기가역성대뇌후부백질뇌병종합정적인식,합리지응용호리정서제고호리질량시치료성공적보증.
Objective To analyze the clinical and nursing care of peripartum reversible posterior leukoencephalopathy syndrome (RPLS).Methods Thirty five cases with peripartum RPLS were retrospectively reviewed.Results All patients developed acutely,22.9％ in the antepartum period and 77.1％ in the postpartum period.The major clinical characteristics were headache (65.7％),seizures(62.9％),visual disturbances (54.3％),altered mental status (22.9％).The most common abnormality on neuro-imaging was edema predominantly involving the cortex and subcortical white matter in the posterior portions of the cerebral hemispheres,including the occipital lobes (77.1％),parietal lobes (65.7％),temporal lobes (28.6％) and frontal lobe (20.0％).MR diffusion-weighted imaging and ADC mapping revealed vasogenic edema.The treatments included aggressive blood pressure control and anticonvulsants with special nursing care.The clinical symptoms and the lesions on neuroimaging improved or resolved within 1 day to 2 months.Conclusions The prognosis for peripartum RPLS is ensured as long as the diagnosis is made properly and reasonable application of care program.