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目的探讨结核病并发韦尼克脑病的病因、临床表现、诊断及处理方法。方法回顾性分析我科2006年—2015年收治的11例结核病合并韦尼克脑病患者的临床资料,并结合文献进行讨论。结果经积极治疗及补充维生素B_1后,6例短期内痊愈;3例部分症状缓解,遗留躯干性共济失调,此3例随访1年后症状完全消失;2例重症患者因延误诊疗死亡。结论结核病慢性消耗明显,或结核性腹膜炎合并肠梗阻需长期禁食者可能导致韦尼克脑病的发生,临床医生要提高重视,及早进行预防性治疗,常规补充VitB_1,避免发生韦尼克脑病。
Objective To investigate the etiology, clinical manifestations, diagnosis and treatment of tuberculosis complicated with Wernicke encephalopathy. Methods The clinical data of 11 tuberculosis patients with Wernicke’s encephalopathy admitted in our department from 2006 to 2015 were retrospectively analyzed and discussed in the literature. Results After active treatment and vitamin B_1 treatment, 6 patients recovered within a short period of time; 3 patients had partial symptom relief and left trunk and ataxia. The symptoms disappeared completely after 1 year of follow-up in 3 patients; 2 patients died of delayed diagnosis and treatment. Conclusion Chronic consumption of tuberculosis is obvious, or tuberculous peritonitis with intestinal obstruction need long-term fasting may lead to the occurrence of Wernicke’s encephalopathy. Clinicians should pay more attention to preventive treatment as soon as possible. VitB_1 should be routinely supplemented to prevent occurrence of Wernicke’s encephalopathy.