第9章 慢性苯妥英钠中毒性脑病1例并文献复习.PDFVIP

临床与病理杂志 2017, 37(1) 216 J Clin Path ol R e s doi: 10.3978/j.issn.2095-6959.2017.01.038 View this article at: /10.3978/j.issn.2095-6959.2017.01.038 慢性苯妥英钠中毒性脑病1例并文献复习 唐伯儒，张硕，刘洋，黄丽玉，郭阳 (中国医科大学附属盛京医院第二神经内科，沈阳 110000) [摘　要] 目的：探讨苯妥英钠 (phenytoin ，PHT) 中毒性脑病的临床特点及诊断治疗要点，以提高神经科医 生对该病的认识。 方法：对 1例慢性PHT 中毒性脑病患者的临床资料、病因、诊断、鉴别诊断及 治疗结合文献进行回顾性分析。 结果：此例患者最初被诊断为缺血性脑血管病，予改善循环等治 疗后未见好转；经详细追问病史、监测血药浓度、腰椎穿刺、脑电图、调整治疗方案后患者明显 好转，出院。 结论：PHT 中毒后临床表现复杂多样，有些不易与脑干或小脑梗死相鉴别，容易误 诊，应提高对其的认识，从而实现早期诊断和治疗。 [关键词] 苯妥英钠；药物过量；中毒性脑病；癫痫 A case of chronic toxic encephalopathy of phenytoin sodium and combination with literature review TANG Boru, ZHANG Shuo, LIU Yang, HUANG Liyu, GUO Yang (Department of Neurology, Shengjing Hospital of China Medical University, Shenyang 110000, China) Abstract Objective: To explore the characteristics of clinic and diagnostic criteria and treatment about toxic encephalopathy of phenytoin sodium. It is essential for us to raise awareness about this disease. Methods: Combined with literatures, retrospectively analysed the features of its pathogeny, classification, clinical characteristics, diagnosis, differential diagnosis, and therapeutic method. Results: This patient was not improved evidently after accepting improving and normalizing the alternated cerebral circulation. Her condition improved and discharged where her medication was adjusted. Conclusion: Clinical manifestations of this disease are complex, which is easily confused with acute cerebellar and bra