1例不典型单纯疱疹病毒性脑炎病人的护理

单纯疱疹病毒性脑炎（herpes simplex virus encephalitis,HSE）是由单纯疱疹病毒（HSV）引起的中枢神经系统常见的病毒性脑炎,发病率国外报道约占人群的4／10万～8／10万,病死率高达70％,仅10％的病人可恢复正常生活能力。近期我科成功救治1例不典型单纯疱疹病毒性脑炎病人,现将护理介绍如下。     

单纯疱疹病毒性脑炎1例的康复护理

我科于１９９９年１１月２日收治１例青少年重症单纯疱疹病毒性脑炎患者，经过６７d的治疗和护理，患者基本治愈。现将护理体会报道如下。１病历摘要患者，男，１８岁，学生，因发热智能异常伴发作性肢体抽搐２个月，言语不能６d，于１９９９年１１月２日收入我院。入院后患者神志不清，表情淡漠，混合性失语，不能张嘴、伸舌，四肢肌张力高，腱反射活跃。自入病室后频繁癫痫发作５～８次／d，２～４min／次，任何声响、强光刺激都可诱发其抽搐，先为左下肢抽动，进而全身强直阵挛发作，同时伴有吞咽困难，饮水呛咳。１１月８日胃管内流出血…     

单纯疱疹病毒性间脑炎1例

患者,女,24岁,主因间断发热1个月,昏睡1周于2007年6月入院.患者缘于入院前1个月因不孕,肌肉注射绒毛膜促性腺激素治疗,此期间出现发热,体温38～39.5℃,头痛、头沉,无恶心、呕吐,在家按上呼吸道感染肌肉注射药物(具体不详)治疗,症状时轻时重,且患者渐出现睡眠增多,进食增多,过度兴奋,定向障碍,言语增多,易怒,非睡眠时间口部不停止地进食、讲话,不能自行控制,体质量增加10余kg,1周前患者出现昏睡,不易被家人唤醒,为进一步诊治来我院.     

1例单纯疱疹病毒性脑炎并发急性视网膜坏死病人的护理

<正>单纯疱疹病毒性脑炎(herpes simplex virus encephalitis,HSE)是由单纯疱疹病毒感染引起的一种急性中枢神经系统感染性疾病,预后相对差,对病人的生活质量影响较大[1]。未经治疗的HSE病死率高达70%以上。典型临床表现为发热、头痛、呕吐、意识障碍、轻微的意识和人格改变、记忆丧失、偏盲、失语、共济失调、多动(震颤、舞蹈样动作、肌阵挛)、脑膜刺激征等;约1/3的病人出现全身性或部分性癫痫发作。此     

单纯疱疹病毒性脑炎

目的 探讨单纯疱疹病毒性脑炎(HSE)的早期临床诊断和治疗。方法 回顾2例以不常见临床症状起病的HSE的临床资料并结合文献复习进行分析。结果 在病毒学检查结果为阴性的情况下，根据临床表现、脑电图和MRI的异常所见作出临床诊断；应用抗病毒和抗癫痫药物治疗效果好。结论 HSE以不常见精神异常、Kluver-Bucy综合征为唯一临床表现，根据脑电图(EEG)、核磁共振检查(MRI)可作出早期临床诊断，定期的MRI随访有利于进一步证实诊断和判断预后。在治疗时，无环鸟苷的治疗时间应依据临床症状的恢复和EEG的改善情况灵活掌握；卡马西平对精神异常及Kluver-Bucy综合征有良好的控制作用。     

成功救治重症单纯疱疹病毒性脑炎1例

患儿女,6个月,因发热3d,伴腹泻1d,惊厥1次于2005年11月14日18:20入院。既往无高热惊厥史。近期无头部外伤史。患儿于入院前3d无明显诱因出现发热,最高体温不详,入院前1d腹泻3次,为黄色稀水样便,量中,无脓     

1例单纯疱疹病毒性脑炎合并急性肠梗阻患者的护理

单纯疱疹病毒性脑炎是由单纯疱疹病毒引起的急性中枢神经系统感染.病变主要侵犯颞叶、额叶和边缘叶脑组织,在病毒性脑炎中是最常见的一种非流行性中枢神经系统感染性疾病.该病20世纪70年代前,病死率较高.20世纪90年代后,抗病毒药阿昔洛韦的广泛应用使该病的病死率明显下降.尽管如此,因其较高的发病率仍成为威胁人类健康的重要疾病[1].肠梗阻是由于各种原因引起肠内容物不能正常运行顺利通过肠腔的一种外科疾病[2].2006年4月我科收治1例单纯疱疹病毒性脑炎合并肠梗阻的患者,已康复出院,现将护理体会介绍如下.……     

1例单纯疱疹病毒性脑炎合并急性肠梗阻患者的护理

单纯疱疹病毒性脑炎是由单纯疱疹病毒引起的急性中枢神经系统感染。病变主要侵犯颞叶、额叶和边缘叶脑组织,在病毒性脑炎中是最常见的一种非流行性中枢神经系统感染性疾病。该病20世纪70年代前,病死率较高。20世纪90年代后,抗病毒药阿昔洛韦的广泛应用使该病的病死率明显下降。     

单纯疱疹病毒性脑炎23例分析

对我院1994-10／2007-05确诊的单纯疱疹病毒性脑炎（HSE）23例分析如下。 1临床资料 1．1一般资料本组男14例，女9例，年龄14～55岁。急性起病18例，亚急性起病5例。诊断标准参照《神经病学》第五版。本组均行脑脊液检查，12例压力稍高，11例正常，18例脑脊液蛋白增高，糖和氯化物正常，13例细胞数稍增高，单纯疱疹病毒抗体（HSV-Ab）测定阳性23例。     

Psychosis and herpes simplex encephalitis

We have reported an unusual presentation of herpes simplex encephalitis in a patient with a 3 1/2-year history of a schizo-affective disorder. In the month immediately before diagnosis, the patient lost contact with reality and became violent. After successful treatment with antipsychotic medication, he had agitation and disorientation, as well as fever and cerebrospinal fluid pleocytosis. There were no focal neurologic findings. When a low-density lesion in the right temporal lobe was defined by computerized axial tomography, brain biopsy and culture isolated herpes simplex virus type 1. After therapy with vidarabine, the patient regained independence in simple daily activities. This case stresses the possibility of herpes simplex encephalitis in patients with an acute mental change.     

1例新型隐球菌型脑炎病人的护理

隐球菌脑膜炎主要是由新型隐球菌通过各种渠道侵入颅内引起的脑膜炎或脑膜脑炎,是最常见的颅内真菌感染。主要的临床症状为头痛、发热、头晕、呕吐、视力模糊或复视等。脑脊液检查做墨汁染色可在显微镜下看到其菌体,病理学检查可见脑膜刺激症状及眼底的视乳头水肿,腰椎穿刺结果     

1例新型隐球菌型脑炎病人的护理

隐球菌脑膜炎主要是由新型隐球菌通过各种渠道侵入颅内引起的脑膜炎或脑膜脑炎。是最常见的颅内真菌感染。主要的临床症状为头痛、发热、头晕、呕吐、视力模糊或复视等。脑脊液检查做墨汁染色可在显微镜F看到其菌体，病理学检查可见脑膜刺激症状及眼底的视乳头水肿，腰椎穿刺结果提示颅内高压。     

Voxel-based morphometry of herpes simplex encephalitis

Voxel-based morphometry (VBM) is a powerful tool for analyzing changes in gray or white matter density of the brain. By using an automated segmentation procedure and standardized parametric statistics it avoids biases inherent in operator-dependent morphological operations (J. Ashburner and K. J. Friston, 2000, NeuroImage 11, 805-821). Since its introduction in 1995, VBM has been used to examine anatomical changes in a variety of diseases associated with neurologic and psychiatric dysfunction. Given the power of this technique for discerning subtle anatomical changes, we wanted to assess its performance on brains with gross structural abnormalities. Such results could have implications regarding the difficulties to be faced when examining other types of distorted brains (e.g., brains with changes due to degenerative disease). This report describes the use of VBM for examining individual and group changes in gray matter concentration in five patients who had recovered from herpes simplex encephalitis (HSE) compared with age- and sex-matched controls. Because HSE tends to affect a specific set of brain regions we thought that this would (1) provide an opportunity to assess the anatomical face validity of VBM, (2) allow us to assess the problems of this technique when used on distorted brains, and (3) provide an in vivo demonstration of the gray matter changes due to HSE. We found that, despite problems in normalizing and segmenting these severely distorted brains, VBM was able to identify correctly a number of the regional gray matter abnormalities in HSE. The results, while consistent with the well-known histopathology of the disease, also demonstrate potential difficulties with this method.     

Atypical manifestations of herpes simplex encephalitis

The diagnosis of herpes simplex encephalitis is readily considered in patients with focal findings on neurologic and radiologic examinations. In the two patients we have described, the diagnosis was delayed because clinical findings were attributed to other medical conditions, and radiologic studies were nondiagnostic. A high index of suspicion and repeated neuroradiologic tests are recommended in patients with unexplained encephalitis.     

1例大疱表皮松解症病人的护理

中毒性大疱表皮松解症(TEN)是药疹中最严重的一种,发病急,全身中毒症状严重,皮损面积大多数在90%以上,皮肤失去屏障功能,若创面处理不当,极易发生败血症、低蛋白血症等.2008年2月我科成功救治1例脑外伤术后并发TEN病人.现将护理体会介绍如下.     

1例Ehlers-Danlos综合征病人的护理

Ehlers-Danlos综合征(EDS)又名弹力过渡性皮肤(cutishyperelastica)、皮肤毛细管破裂(dermatorrhexis)、伴皮肤和关节松弛的皮肤毛细管破裂(dermatorrhexis with dermatochala-sis)、弹力皮肤(cutis elastica)等.     

1例麦胶性肠病的护理

麦胶性肠病(gluten-induced enteropathy)又称乳糜泻(coeliac disease,CD)是遗传易感者摄入麸质(小麦、大麦、稞麦、燕麦等)后,由免疫系统介导的以乳糜样腹泻为主的全身性疾病.既往认为本病高发于美国、欧洲和澳大利亚,在欧美发病率高达1/122~1/300,而随着CD诊断技术的逐渐成熟,越来越多的证据表明欧洲以外的国家,比如亚洲国家、中东地区,乳糜泻的患病率比实际想象的更高.