医学综述
醫學綜述
의학종술
MEDICAL RECAPITULATE
2015年
15期
2752-2754
,共3页
杨澄清(综述)%陆兰英(审校)
楊澄清(綜述)%陸蘭英(審校)
양징청(종술)%륙란영(심교)
结核性脑膜炎%低钠血症%抗利尿激素分泌异常综合征%脑耗盐综合征
結覈性腦膜炎%低鈉血癥%抗利尿激素分泌異常綜閤徵%腦耗鹽綜閤徵
결핵성뇌막염%저납혈증%항이뇨격소분비이상종합정%뇌모염종합정
Tuberculous meningitis%Hyponatremia%Syndrome of inappropriate antidiuretic hormone%Cerebral salt wasting syndrome
结核性脑膜炎( TBM)是结核病中最严重的一种。低钠血症是 TBM 常见的并发症。 TBM合并低钠血症可加重脑水肿,导致颅内高压,甚至脑疝形成,处理不及时可危及生命。 TBM合并低钠血症最重要的两个原因是抗利尿激素分泌异常综合征和脑耗盐综合征。由于两者临床表现类似,导致诊断困难,容易漏诊、误诊,如果治疗不当会导致病情加重或死亡。及早发现及明确 TBM 合并低钠血症的原因,及时给予针对性治疗,可能有效降低TBM患者的病死率。
結覈性腦膜炎( TBM)是結覈病中最嚴重的一種。低鈉血癥是 TBM 常見的併髮癥。 TBM閤併低鈉血癥可加重腦水腫,導緻顱內高壓,甚至腦疝形成,處理不及時可危及生命。 TBM閤併低鈉血癥最重要的兩箇原因是抗利尿激素分泌異常綜閤徵和腦耗鹽綜閤徵。由于兩者臨床錶現類似,導緻診斷睏難,容易漏診、誤診,如果治療不噹會導緻病情加重或死亡。及早髮現及明確 TBM 閤併低鈉血癥的原因,及時給予針對性治療,可能有效降低TBM患者的病死率。
결핵성뇌막염( TBM)시결핵병중최엄중적일충。저납혈증시 TBM 상견적병발증。 TBM합병저납혈증가가중뇌수종,도치로내고압,심지뇌산형성,처리불급시가위급생명。 TBM합병저납혈증최중요적량개원인시항이뇨격소분비이상종합정화뇌모염종합정。유우량자림상표현유사,도치진단곤난,용역루진、오진,여과치료불당회도치병정가중혹사망。급조발현급명학 TBM 합병저납혈증적원인,급시급여침대성치료,가능유효강저TBM환자적병사솔。
Tuberculous meningitis(TBM) is one of the most serious of tuberculosis.Hyponatremia is a common complication of TBM.TBM complicated with hyponatremia can aggravate cerebral edema,lead to intracranial hypertension,even cerebral hernia,and can endanger life without timely treatment.The two most important reasons of TBM complicated hypnatiremia are syndrome of inappropriate antidiuretic hormone and cerebral salt wasting syndrome.Because the clinical manifestations of the two syndromes are similar ,the diag-nosis is difficult,with easy missed diagnosis or misdiagnosis,and inappropriate treatment may lead to aggrava-tion or death.Early detection and clarification of reasons for TBM complicated with hyponatremia ,and timely targeted therapy,may effectively reduce the mortality of patients with TBM .