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目的分析总结15例临床诊断伴颅内结构受累的Ramsay-Hunt综合征的临床资料特点及治疗效果,以提高对本病的认识和诊断水平。方法回顾性分析2007～2011年收治的经临床证实的15例伴颅内结构受累的Ramsay-Hunt综合征,记录总结其临床特点、实验室检查、治疗效果等临床资料。结果 15例患者中男性5例,女性10例,年龄18～80岁,冬春季多发。累及脑膜者10例,累及脑、脑干者5例,同时累及脑膜、脑、脑干者2例。15例患者临床多表现为偏侧面瘫、外耳道疱疹、听力减退、意识障碍、锥体束征等。脑膜受累者治疗有效率为90%,脑干受累者治疗有效率为80%。结论 Ramsay-Hunt综合征合并颅内结构受累患者临床表现多种多样,易漏诊。偏侧面瘫、外耳道疱疹、听力减退是最常见的临床表现,同时合并脑膜、脑及脑干受累症状。及早发现诊断,静脉使用阿昔洛韦积极治疗,效果较好。
Objective To analyze and summarize the clinical data of 15 cases of Ramsay-Hunt syndrome complicated with intracranial structures involved in clinical diagnosis and treatment, so as to improve their understanding and diagnosis of this disease. Methods The clinical data of 15 Ramsay-Hunt syndromes with intracranial structures clinically confirmed from 2007 to 2011 were retrospectively analyzed. The clinical features, laboratory tests and treatment effects were recorded and summarized. Results Among the 15 patients, there were 5 males and 10 females, aged from 18 to 80 years old, with multiple senescence in winter and spring. Ten cases of meninges were involved, including 5 cases of brain and brain stem, and 2 cases of meninges, brain and brainstem involvement. 15 cases of clinical manifestations of hemiplegia, external auditory canal herpes, hearing loss, disturbance of consciousness, pyramidal tract signs and so on. The effective rate of treatment of meningeal involvement was 90%, effective treatment of brain stem involvement was 80%. Conclusion The clinical manifestations of patients with Ramsay-Hunt syndrome complicated by intracranial structures are diverse and easily missed. Lateral paralysis, external auditory canal herpes, hearing loss is the most common clinical manifestations, combined with meninges, brain and brainstem involvement symptoms. Early detection of diagnosis, intravenous acyclovir active treatment, the effect is better.