高渗高血糖综合征合并非酒精性韦尼克脑病一例报道并文献复习  

Hyperosmolar Hyperglycemic Syndrome Combined with Non-alcoholic Wernicke's Encephalopathy:a Case Report and Literature Review

作　　者：王绮 高冠起[2] 杜文华[2] 王宪丽 WANG Qi;GAO Guanqi;DU Wenhua;WANG Xianli(Second Clinical Medical College of Binzhou Medical College,Yantai 264003,China;Department of Endocrinology,Linyi People's Hospital,Linyi 276000,China;Weifang Medical College,Weifang 261053,China)

机构地区：[1]滨州医学院第二临床医学院,山东省烟台市264003 [2]山东省临沂市人民医院内分泌科,276000 [3]潍坊医学院,山东省潍坊市261053

出　　处：《实用心脑肺血管病杂志》2023年第11期132-135,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：韦尼克脑病(WE)是临床上罕见的代谢性脑病,其起病隐匿,临床表现多样,鉴别诊断困难。高渗高血糖综合征(HHS)合并非酒精性WE鲜有报道,两种疾病症状和体征重叠,使WE的鉴别诊断更加困难,更易漏诊。本文报道1例HHS合并非酒精性WE患者的诊疗经过,经WE诊断性治疗——硫胺素肌肉注射后患者精神状态明显好转,愈后良好。本文同时通过查阅相关文献,总结WE的临床特征、影像学表现、治疗及预后,以提高临床医生对此病的认识,降低WE的漏诊率。Wernicke's encephalopathy(WE)is a rare metabolic encephalopathy in clinical practice,with insidious onset,diverse clinical manifestations,and difficult differentiation.There are few reports of hyperosmolar hyperglycemic syndrome(HHS)combined with non-alcoholic WE,the overlapping symptoms and signs of the two diseases make it more difficult to distinguish WE and make it easier to miss diagnosis.This paper reports the diagnosis and treatment of a patient with HHS combined with non-alcoholic WE.After WE diagnostic therapy——thiamine intramuscular injection,the patient's mental state improved significantly and recovered well.Meanwhile,this paper summarizes the clinical features,imaging manifestations,treatment,and prognosis of WE by reviewing the relevant literature,in order to improve clinical doctors'understanding of this disease,and reduce missed diagnosis rates.

关 键 词：韦尼克脑病 高血糖高渗性非酮性昏迷 高渗高血糖综合征 硫胺素 病例报告 

分 类 号：R746.4[医药卫生—神经病学与精神病学] R587.2[医药卫生—临床医学]