妊娠期可逆性后部脑病综合征六例临床研究

Clinical research of six cases posterior reversible encephalopathy syndrome in pregnancy

目的探讨妊娠期可逆性后部脑病综合征（PRES）的临床特征，以利早期诊断、及时治疗和改善预后。方法收集南京医科大学附属苏州医院2011年1月至2016年6月共收治6例PRES患者的临床资料进行回顾性分析。结果6例患者，均有血压升高病史，4例系子痫前期-子痫，1例双胎，1例妊娠期急性脂肪肝，4例患者于产前发病，2例患者于产后发病，均出现头痛，视物改变，抽搐伴意识障碍，行MRI检查提示脑部不同部位存在低密度病灶，经过积极降压解痉脱水等治疗，均恢复正常。结论子痫前期为PRES的主要高危因素之一。对于子痫前期孕妇出现神经系统症状应考虑PRES，需行头颅磁共振明确诊断，及早发现及时治疗，提高对该病的认识。

Objective To investigate the clinic features,diagnosis, therapy and prognosis of posterior reversible encephalopathy syndrome（PRES）. Methods A retrospective study was conducted on clinical data of 6 PRES in Suzhou Hospital Affiliated to Nanjing Medical University from January 2011 to July 2016. Results Of 6 cases with hypertension,4 cases of preeclampsia - eclampsia, 1 case of twin pregnancy, 1 case of pregnancy with acute fatty liver,4 patients in prenatal disease, 2 patients developed postpartum disease,have headaches, visual changes, convulsions with disturbance of consciousness, MRI examination suggests that there are low-density lesions in different parts of the brain,after a positive antihypertensive antispasmodic dehydration and other treatment, are back to normal. Conclusion Preeclampsia is one of the important causes of PRES. Pregnant women with preeclampsia neurological symptoms should be considered PRES, Head MRI can confirm the diagnosis, Early detection and timely treatment, to raise awareness of the disease.