临床误诊误治
臨床誤診誤治
림상오진오치
CLINICAL MISDIAGNOSIS & MISTHERAPY
2015年
5期
42-46
,共5页
郑乾%秦利霞%谭利明%胡治平%张海南
鄭乾%秦利霞%譚利明%鬍治平%張海南
정건%진리하%담리명%호치평%장해남
子痫性脑病%误诊%静脉血栓形成%脑梗死
子癇性腦病%誤診%靜脈血栓形成%腦梗死
자간성뇌병%오진%정맥혈전형성%뇌경사
Eclamptic encephalopathy%Diagnostic error%Venous thrombosis%Brain infarction
目的:探讨子痫性脑病的临床特点、诊治措施、误诊原因及其防范措施。方法对我科收治的曾误诊的产后子痫性脑病2例的临床资料进行回顾性分析。结果2例分别于产后9h、6d以抽搐、头痛、视力障碍起病,皆无高血压病及癫痫病史,发病时血压稍高于正常,尿蛋白定性(-),初期均误诊为神经内科疾病,均结合病史、临床表现及医技检查结果诊断产后子痫性脑病。给予相应治疗,临床症状消失,治愈出院。随访2个月未再发生类似表现。结论临床遇及产后出现头痛、视力障碍、恶心、呕吐及抽搐等表现者应考虑子痫性脑病的可能。早期MRI检查对子痫性脑病诊断具有重要作用。尽早明确诊治,有助于其改善预后。
目的:探討子癇性腦病的臨床特點、診治措施、誤診原因及其防範措施。方法對我科收治的曾誤診的產後子癇性腦病2例的臨床資料進行迴顧性分析。結果2例分彆于產後9h、6d以抽搐、頭痛、視力障礙起病,皆無高血壓病及癲癇病史,髮病時血壓稍高于正常,尿蛋白定性(-),初期均誤診為神經內科疾病,均結閤病史、臨床錶現及醫技檢查結果診斷產後子癇性腦病。給予相應治療,臨床癥狀消失,治愈齣院。隨訪2箇月未再髮生類似錶現。結論臨床遇及產後齣現頭痛、視力障礙、噁心、嘔吐及抽搐等錶現者應攷慮子癇性腦病的可能。早期MRI檢查對子癇性腦病診斷具有重要作用。儘早明確診治,有助于其改善預後。
목적:탐토자간성뇌병적림상특점、진치조시、오진원인급기방범조시。방법대아과수치적증오진적산후자간성뇌병2례적림상자료진행회고성분석。결과2례분별우산후9h、6d이추휵、두통、시력장애기병,개무고혈압병급전간병사,발병시혈압초고우정상,뇨단백정성(-),초기균오진위신경내과질병,균결합병사、림상표현급의기검사결과진단산후자간성뇌병。급여상응치료,림상증상소실,치유출원。수방2개월미재발생유사표현。결론림상우급산후출현두통、시력장애、악심、구토급추휵등표현자응고필자간성뇌병적가능。조기MRI검사대자간성뇌병진단구유중요작용。진조명학진치,유조우기개선예후。
Objective To explore the clinical features, methods of diagnosis and treatment, misdiagnosis causes and preventive measures for eclamptic encephalopathy. Methods Clinical data of 2 misdiagnosed patients with postpartum eclamptic encephalopathy admitted to our department were retrospectively analyzed. Results The 2 patients suffered from headache, convulsions and visual disturbances 9 h and 6 d after giving birth. Their blood presure was a little bit above normal and urine protein was negative, and neither of them had hypertension or epilepsy history. Both of the patients were misdiagno-sis as having a neurological disease at first and then the diagnosis was corrected and then the patients were given the right treatment in accordance with their medical history, clinical manifestations and medical examination. They had a good recovery and had no further seizures upon discharge 2 month later. Conclusion Clinicians should take the eclamptic encephalopathy into consideration for postpartum women who suffer from headache, visual disturbances, nausea, vomiting and convulsion. The MRI examination plays an important role in the prophase diagnosis. The earlier diagnosis and treatment are taken, the better the prognosis will be.