肾综合征出血热并发神经系统损伤的诊治

MANAGEMENT OF HEMORRHAGIC FEVERRENAL SYNDROME COMPLICATED WITH NERVOUS SYSTEM SYMPTOMS

目的：进一步掌握肾综合征出血热并发神经系统损伤的临床特征和诊治要点。方法：总结具有神经精神症状的肾综合征出血热患者２１例，分析了临床特征及常见的诱发因素。结果：临床特征为头痛、呕吐、神志恍惚、嗜睡、晕厥、谵语、抽搐和（或）脑膜刺激征。诱发因素主要见于：①脑组织缺血缺氧；②高血容量综合征；③低钠性脑病；④尿毒症性脑病；⑤出血性脑损伤等。结论：肾综合征出血热并发神经系统损伤并非少见，应引起临床足够重视。早期识别和妥善处理对预后至关重要。

Objective:In order to master the clinical features and diagnostic guides for hemorrhagic feverrenal syndrome(HFRS) with nervous system symptoms.Methods:The clinical characteristic and inducing factors in 21 case of HFRS with nervous and spiritual symptoms were analyzed.Results:The clinical features were headache,vomiting,absence of mind,somnolence,syncope,delirium,twitch and /or meningeal irritation.The predisposing factors were blood and oxygen shortage in brain cells,high blood capacity syndrome,hyponatremia encephalopathy,uremia encephalopathy,hemorrhagic brain damage, et al.Conclusion:HFRS associated with nervous system damage is common and should attract attention.Early dignosis and proper treatment are important.