Wallenberg综合征15例临床分析

Wallenberg Syndrome:Clinical Analysis of 15 Cases

目的探讨Wallenberg综合征临床特点、治疗方法及预后。方法回顾性分析15例Wallenberg综合征患者的临床资料。结果本组患者以急性或亚急性起病，以眩晕（10／15）、构音障碍（9／15）、吞咽困难（7／15）、Homer征（11／15）、共济失调（8／15）及交叉性感觉障碍（8／15）为常见临床表现。15例行MRI检查均显示延髓背外侧梗死。11例采用抗凝、抗血小板、活血化瘀治疗，4例采用东菱抗栓酶治疗，其中10例于7～10d后症状缓解，1～2个月后症状基本消失，4例遗留不同程度的感觉障碍和共济失调，1例死亡。结论动脉粥样硬化致椎基底动脉血栓形成是Wallenberg综合征的主要病因但不是惟一原因，本病经积极治疗预后较好。

Objective To investigate the clinical characteristics, therapy and prognosis of Wallenberg syndrome （WS）. Methods The clinical data of 15 cases with WS were analyzed retrospectively. Results In these patients, WS started with acute or subacute attack, and its main common clinical manifestations were circumgyration （10/15）, dysarthria （9/ 15）, acataposis （7/15）, Homer sign （ 11/15 ）, ataxia （ 8/15 ） and crossed sensory disability （ 8/15 ）. MRI examination was performed on all the patients to display dorsolateral bulbar infarction. 11 patients were treated with anticoagulation, anti-platelet and promotion of blood circulation to regulate menstruation, and 4 were given Dongling Ahylysantinfarctase. Symptoms relieved after 7 -10 days and disappeared by and large after 1 -2 months in 10 patients, different extents of sensory disability and ataxia remained in 4 patients and one patient died. After treatment, the recovery from the symptoms of circumgyration, nausea, vominting, hoarse voice and acataposis was faster, but the recovery from sensory disability and ataxia was the lowest. Conclusion Basilar artery thrombosis due to artherosclerosis is the main but not the only cause of Wallenberg syndrome. Active treatment can offer a better prognosis.