尿毒症脑病20例临床研究

目的：研究尿毒症脑病的临床特征，减少误诊、误治。方法：对20例临床诊断为尿毒症性脑病患者进行研究，对其诊治、预后进行分析。结果：20例患者中临床表现有意识障碍3例，精神症状12例，癫痫发作6例，不自主运动6例，中枢盲1例，12例脑电图异常，均表现为弥漫性慢波，全部作CT检查，做MRI检查8例。脑萎缩12例，6例检出14个低密度病灶或／和长T1、T2异常信号灶，依次为基底节4个、放射冠区2个、枕叶1个、丘脑2个、颞叶1个、桥脑2个、岛叶、顶叶各1个，大小在0．3cm×0．4cm-0．6cm×0．9cm，类图形，边缘清楚；CT图像呈低密度影，CT值17—23Hu，而MRI图像上呈长T1和长T2异常信号。均接受透析治疗，2例死亡，治愈6例，有效12例。结论：尿毒症性脑病临床表现多样，及时诊治可提高存活率。

Clinical analysis of 20 cases with uremic encephalopathy

Objective To study the clinical characteristics of uremic encephalopathy,and reduce misdiagnosis and mistreatment.MethodThe diagnosis,treatment and prognosis of 20 cases clinically diagnosed of uremic encephalopathy were analysed.ResultsAmong 20 patients with the following clinical manifestations:3 cases of disturbance of consciousness,12 cases with mental symptoms,6 cases of epilepsy,6 cases of involuntary movement and 1 case of central blindness.For 12 cases with EEG abnormality all showed diffuse slow-wave,and all for CT examination,8 for MRI examination.For 12 cases with brain atrophy,14 low-density lesions were detected in 6 cases and / or long-T1,T2 abnormal signal lesions,followed by 4 in basal ganglia,2 in corona radiata district,1 in occipital,2 in hypothalamus,1 in temporal lobe,2 in pons,1 in insular and 1 in parietal lobe.The size was 0.3cm × 0.4cm～0.6cm × 0.9cm,with type of graphics and clear edge.CT images showed low-density shadow,CT value of 17 ～ 23Hu,and MRI images arranged long T1 and T2 signal abnormalities.All the patients received dialysis treatment,and 2 cases died,6 cases cured,12 cases of effect.ConclusionThe clinical manifestations of uremic encephalopathyis diverse,timely diagnosis and treatment can improve survival rate.