产后子痫性脑病误诊分析

Analysis of Misdiagnosis of Postpartum Eclampsia Encephalopathy

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9 h、6 d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。

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.