创伤性脑损伤后阵发性交感神经过度兴奋综合征的研究进展

Research progress of paroxysmal sympathetic hyperactivity syndrome following traumatic brain injury

阵发性交感神经过度兴奋综合征(PSH)是中重度创伤性脑损伤(TBI)后一种常见的并发症,以同时、阵发性的交感神经兴奋性增加(高热、血压升高、心率增快、呼吸急促、大汗)和姿势或肌张力障碍为特征。PSH的临床表现存在个体差异,症状缺乏特异性,早期易与脓毒症、癫痫等疾病相混淆。目前PSH的发病机制尚未明确,诊断主要通过临床表现及排除其他疾病,因此易造成误诊及治疗延迟,最终阻碍TBI患者的康复过程。本文就创伤性脑损伤后PSH的临床特点、发病机制、诊断、治疗等进行综述,以期为PSH的早期诊断、治疗提供指导。

Paroxysmal sympathetic hyperactivity(PSH)syndrome is a common complication after moderate to severe traumatic brain injury(TBI).It is characterized by simultaneous and paroxysmal increase in sympathetic excitability(high fever,elevated blood pressure,increased heart rate,tachypnea,hyperhidrosis)and postural or muscular tension disorders.There are individual differences in the clinical manifestations of PSH,the symptoms are lack of specificity,and it is easy to be confused with sepsis,epilepsy and other diseases at the early stage.At present,the pathogenesis of PSH is not clear,and the diagnosis is mainly through clinical manifestations and exclusion of other diseases.It is usually misdiagnosed and delayed in treatment,and ultimately hinder the rehabilitation process of TBI patients.At present,the treatment of PSH is mainly preventing and controlling symptoms,and there is still no unified and effective management plan,which affects the prognosis of TBI.This article reviews the clinical characteristics,pathogenesis,diagnosis and treatment of PSH after traumatic brain injury in order to provide guidance for the early diagnosis and treatment of PSH.