目的：进一步掌握肾综合征出血热并发神经系统损伤的临床特征和诊治要点。方法：总结具有神经精神症状的肾综合征出血热患者２１例，分析了临床特征及常见的诱发因素。结果：临床特征为头痛、呕吐、神志恍惚、嗜睡、晕厥、谵语、抽搐和（或）脑膜刺激征。诱发因素主要见于：①脑组织缺血缺氧；②高血容量综合征；③低钠性脑病；④尿毒症性脑病；⑤出血性脑损伤等。结论：肾综合征出血热并发神经系统损伤并非少见，应引起临床足够重视。早期识别和妥善处理对预后至关重要。 Objective: To further understand the clinical features and diagnosis and treatment of hemorrhagic fever with renal syndrome complicated by nervous system injury. Methods: Twenty-one patients with hemorrhagic fever with renal syndrome and neuropsychiatric symptoms were summarized and their clinical characteristics and common predisposing factors were analyzed. Results: The clinical features were headache, vomiting, delirium, lethargy, syncope, malaria, convulsions and / or meningeal irritation. Induced factors mainly seen in: ① brain ischemia and hypoxia; ② hypervolemic syndrome; ③ hyponatremia; ④ uremic encephalopathy; ⑤ hemorrhagic brain injury. Conclusion: Hemorrhagic fever with renal syndrome complicated by nervous system injury is not uncommon, which should be paid enough attention in clinic. Early identification and proper management of the prognosis is crucial.