成功救治妊娠合并脑炎继发多脏器功能障碍综合征一例
A Case of the Successful Treatment of a Pregnancy Woman Was Complicated Byencephalitis and Multiple Organ Dysfunction Syndromes

作者: 张京晓 , 刘海波 * , 尹永杰 :吉林大学第二医院急救医学科;

关键词: 妊娠脑炎多器官功能障碍综合征Pregnancy Encephalitis Multiple Organ Dysfunction Syndromes (MODS)

摘要:
年轻女性,妊娠20周,因发热、寒战3天入院,入院后因血小板减少入我院血液科,次日出现抽搐,第3日出现意识障碍转入ICU,化验检查提示患者存在死胎、呼吸衰竭、休克、肝损伤、肾损伤、胃肠功能及凝血功能障碍等,诊断为:脑炎、多器官功能障碍综合征、休克、死胎,经机械通气,持续心电监护,CVP监测,抗休克、激素冲击、抗癫痫,亚低温治疗,纠正凝血功能,多器官功能支持及早期营养支持治疗,第5天诱导分娩出1女性死婴,经20余天治疗后,患者神志清楚,四肢肌力3~4级,可正常饮食各项化验指标基本恢复正常,痊愈出院。
A young pregnancy women suffered from fever for 3 days and came to our hospital. After admission to the hematology department because of thrombocytopenia, in the third day coma appears and she was deliveried to ICU department. Our lab finding suggests that the patient presented respiratory failure, shock, liver injury, renal injury, ga-strointestinal dysfunction and coagulation dysfunction. Consider of that, the diagnosis was encephalitis, multiple organ dysfunction syndrome, shock, and stillbirth. Then we give her the treatment including the mechanical ventilation, mon-itoring CVP, fluid resuscitation, large dose glucocorticoid injection, and mild hypothcrmia, sedation, coagulating, organ support and early nutrition support therapy. And on the 5th day, a dead female baby was delivered, after more than 20 days treatment, the patient was clear. Muscle power was 3-4 level in the four limbs, lab finding returns to normal, the patient was discharged.

文章引用: 张京晓 , 刘海波 , 尹永杰 (2013) 成功救治妊娠合并脑炎继发多脏器功能障碍综合征一例。 亚洲急诊医学病例研究, 1, 5-7. doi: 10.12677/ACREM.2013.11003

参考文献

[1] 张川荛, 李树清. 脑缺血后适应脑保护的研究进展[J]. 中国病理生理杂志, 2011, 27(5): 1025-1028.

[2] 宿英英. 危重脑功能损伤的脑保护[J]. 中华脑血管病杂志, 2008, 2(2): 124-128.

[3] M. R. Cilio, D. M. Ferriero. Synergistic neuroprotective therapies with hypothermia. Seminars in Fetal & Neonatal Medicine, 2010, 15(5): 293-298.

[4] 王超, 苏强, 张淑文等. 多器官功能障碍综合征病情严重度评分系统[J]. 中国医学科学院学报, 2007, 14(4): 497-500.

分享
Top