重型颅脑创伤术后发作性自主神经功能紊乱:四例报告并文献复习

Paroxysmal autonomic nerve dysfunction after severe traumatic brain injury surgery:four cases report and review of literature

发作性自主神经功能紊乱是一种临床较为少见的综合征,主要表现为交感神经兴奋、副交感神经兴奋或二者兼有的症状与体征。由于早期临床表现复杂、诊断困难,易误诊为医原性感染、中枢性高热等。本文4例重型颅脑创伤患者均于手术后出现发作性自主神经功能紊乱症状,经溴隐亭、普萘洛尔,以及物理降温和高压氧治疗症状明显改善。

Paroxysmal autonomic nerve dysfunction is a relatively rare clinical syndrome,and is clinically diagnosed based on the combined presence of sympathetic hyperactivity and parasympathetic hyperactivity.Early diagnosis of paroxysmal autonomic nerve dysfunction is difficult because its early clinical manifestations are complicated and varied,and it is easily misdiagnosed as central high fever,hospital infection,and so on.The causes and mechanism of the disease are complex,and there is no effective preventive measures.This paper will report 4 cases of patients with severe traumatic brain injury （TBI） who suffered from episodes of this disease.The effective therapies include bromocriptine,propranolol,physical cooling and hyperbaric oxygen therapy.The report also provides review of literature about paroxysmal autonomic nerve dysfunction,in order to improve diagnosis and treatment of the disease.