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目的探讨可逆性后部脑病综合征(PRES)的临床表现和诊治要点。方法回顾性分析苏州市立医院近4年发生的6例PRES临床资料。结果围产期PRES常见于子痫前期/子痫,主要以头痛,视力模糊,抽搐和意识障碍为临床表现,常伴有血压升高,实验室检查提示乳酸脱氢酶和尿酸升高,头颅CT或者MRI提示大脑皮质下白质部位出现异常病灶,累及枕叶,额叶,颞叶,基底节和小脑等部位,可以伴有肺部渗出和胸腔积液。结论 PRES是以大脑白质损害为主要神经影像学表现的临床综合征,及时诊断,积极终止妊娠和对症治疗可使病情迅速缓解。
Objective To investigate the clinical manifestations and diagnosis and treatment of reversible posterior encephalopathy syndrome (PRES). Methods The clinical data of 6 PRESs in Suzhou Municipal Hospital during the recent 4 years were retrospectively analyzed. Results Perinatal PRES commonly found in preeclampsia / eclampsia, mainly in the clinical manifestations of headache, blurred vision, convulsions and disturbance of consciousness, often accompanied by elevated blood pressure, laboratory tests showed elevated lactate dehydrogenase and uric acid, head CT or MRI showed abnormal cortical white matter lesions in the cortex, involving the occipital lobe, frontal lobe, temporal lobe, basal ganglia and cerebellum and other parts, may be associated with pulmonary exudate and pleural effusion. Conclusions PRES is a clinical syndrome characterized by white matter damage of the brain as the main neuroimaging diagnosis. The timely diagnosis of symptomatic treatment of active termination of pregnancy and symptomatic treatment can quickly relieve the symptoms.