脑炎合并肠梗阻的临床特征分析

Clinical Characteristics Analysis of Encephalitis Complicated with Intestinal Obstruction

目的 分析脑炎合并肠梗阻患者的临床资料,了解其临床特征和可能的病因。方法 收集郑州大学第一附属医院自2019年10月到2022年3月收治的12例脑炎合并肠梗阻患者的临床资料,分析数据并检索学习相关文献,分析其可能的发病机制。结果 12例患者中神经系统症状主要表现为发热(58.33%)、头痛(25.00%)、肢体无力(33.33%)、精神行为异常(16.67%)、意识障碍(66.67%)。胃肠道症状主要表现为腹胀(100.00%)、腹痛(41.67%)。其中8例红细胞降低(66.67%),8例血红蛋白降低(66.67%),12例红细胞比容降低(100.00%)。1例接受血浆置换、丙球及激素冲击治疗,11例接受抗病毒治疗。所有患者均接受禁食、灌肠、促进肠蠕动治疗。11例预后较好,1例死亡。结论 脑炎合并肠梗阻患者有明显的肢体活动障碍以及低红细胞、血红蛋白、红细胞比容,临床医生应关注脑炎患者肢体活动状况,及时改善贫血,另外应关注患者排便情况,必要时行腹部立位片或腹部CT检查,及时处理。非胃肠道原因出现的肠梗阻症状,也应考虑脑炎可能。

Objective To analyze the clinical data of patients with encephalitis complicated with intestinal obstruction,and understand the clinical characteristics and possible causes.Methods Clinical data of 12 patients with encephalitis complicated with intestinal obstruction who were hospitalized in the First Affiliated Hospital of Zhengzhou University from October 2019 to March 2022 were collected and analyzed.Analyzed the data and searched relevant literature to investigate the possible pathogenesis.Results The neurological symptoms among the 12 patients included fever(58.33%),headache(25.00%),limb weakness(33.33%),psychiatric and behavioral abnormalities(16.67%),and consciousness disturbance(66.67%).Gastrointestinal symptoms were mainly abdominal bloating(100.00%)and abdominal pain(41.67%).Among the 12 patients,8 patients(66.67%)had decreased erythrocyte,8 patients(66.67%)had decreased hemoglobin,and 12 patients(100.00%)had decreased hematocrit.One case received plasma exchange,gamma globulin and hormone shock therapy,and 11 cases received antiviral therapy.All patients were treated with fasting,enema and intestinal peristalsis promotion.The prognosis of 11 cases was good,and 1 case died.Conclusion The patients with encephalitis complicated with intestinal obstruction have obvious limb dyskinesia and low red blood cells,hemoglobin and hematocrit.Clinicians should pay attention to the physical activity of patients with encephalitis,correct anemia in time,pay attention to the defecation of patients,and if necessary,abdominal X-ray and/or CT imaging should be performed for timely treatment.Encephalitis should also be considered for the non-gastrointestinal etiology of intestinal obstruction.