摘要
目的:探讨子痫前期并可逆性后部白质脑病综合征(reversible posterior leukoencephalopathy syndrome,RPLS)的临床表现、影像学特点,以便早诊断、早治疗,获得良好的预后。方法:回顾性分析57例病例报道及同仁医院发生的1例子痫前期并可逆性后部白质脑病综合征。结果:产前46例,产后9例,3例发生时间不详。58例均有高血压、蛋白尿伴头痛、视物不清、进而皮质盲。58例中30人行头颅CT检查,2l例未发现异常,7例表现为局灶性低密度改变,以双侧枕部多见,2例表现为病灶广泛、弥漫性水肿。19例行头颅MRI,5例未发现异常,12例提示后部脑白质血管源性水肿。积极治疗、及时终止妊娠视力完全恢复47例,2例视力未恢复,8例未报结局,1例入院后未及时终止妊娠19 h死于脑出血。结论:高血压、蛋白尿伴头痛、皮质盲是子痫前期伴RPLS常见的临床表现,其特点是可逆性大脑皮质性视觉障碍,MRI是诊断的首选方法;早期诊断,及时终止妊娠,合理治疗,预后良好。
Objective：To explore the clinical manifestations and imaging features of preeclampsia combined with reversible posterior leukoencephalopathy syndrome（RPLS）,in order to diagnose and cure early,achieve a good prognosis. Methods：57 case reports and one case with preeclampsia combined with RPLS in the hospital were analyzed retrospectively. Results：46 pregnant women,9 postpartum women and 3 women with unknowing occurrence time were included in the study;all the women had the clinical manifestations including hypertension,proteinuria combined with head ache,not being able to see clearly and then cortical blindness;among the 58 women,30 women received head CT scanning,21 women were normal,7 women were found with focal low density changes,mostly locating in bilateral occipitalia,2 women were found with focal extensive and diffuse edema;19 women received head MRI,5 women were normal,12 women were found with posterior cerebral white matter vasogenic edema;after active treatment and timely termination of pregnancy,the vision of 47 women returned to normal,while the vision of 2 women didn＇t return to normal,8 women didn＇t report their visional outcomes,one woman died of cerebral hemorrhage because of delayed termination of pregnancy. Conclusion：Hypertension,proteinuria combined with head ache and cortical blindness are common clinical manifestations of preeclampsia combined with RPLS,reversible cerebral cortical visual disorder is its feature,MRI is the preferred diagnostic method;early diagnosis,termination of pregnancy timely and proper treatment may obtain a good prognosis.
出处
《中国妇幼保健》
CAS
北大核心
2011年第9期1314-1316,共3页
Maternal and Child Health Care of China
关键词
子痫前期
可逆性后部白质脑病综合征
临床特点
影像学
Preeclampsia； Reversible posterior leukoencephalopathy syndrome； Clinical characteristics； Imaging
