慢性酒精中毒致脑桥中央髓鞘溶解症5例临床分析  

Clinical Analysis of 5 Cases of Central Pontine Myelinolysis Due to Chronic Alcoholism

作　　者：唐运立 黄肖喜 

机构地区：[1]广西大化瑶族自治县人民医院内三科,广西 大化

出　　处：《临床医学进展》2022年第4期3356-3359,共4页Advances in Clinical Medicine

摘　　要：目的:分析慢性酒精中毒致脑桥中央髓鞘溶解症(central pontine myelinolysis, CPM)的临床表现,影像特点及治疗预后。方法:对2014-01~2020-06收住广西大化瑶族自治县人民医院住院的CPM患者临床资料进行回顾,结合文献进行分析。结果:5例患者中4例有电解质紊乱,仅1例血电解质正常,4例有电解质紊乱中3例有低钠血症,其中2例有低钠同时并低钾血症、低氯血症,1例有低氯血症。临床主要表现为肢体无力,精神症状,延性麻痹。5例患者均使用类固醇激素治疗,并结合康复治疗,治疗后病情稍好转1例,无明显缓解3例,死亡1例。结论:慢性酒精中毒致脑桥中央髓鞘溶解症患者治疗预后不佳。Objective: To analyze the clinical manifestations, imaging features and prognosis of central pontine myelinolysis (CPM) due to chronic alcoholism. Methods: The clinical data of CPM patients admitted to Dahua Yao Autonomous County People’s Hospital from January 2014 to June 2020 were reviewed and analyzed with the literature. Results: Among the 5 patients, 4 had electrolyte imbalance, of which 3 had hyponatremia, 2 had hypokalemia, hyponatremia and hypochloremia, 1 had hypochloremia. Only 1 patient showed normal serum electrolytes. The main clinical manifestations were limb weakness, mental symptoms, and bulbar paralysis. All 5 patients were treated with steroid therapy combined with rehabilitation therapy. After treatment, 1 patient’s condition improved slightly, 3 patients had no obvious improvement, and 1 patient died. Conclusion: The prognosis of patients with central pontine myelinolysis due to chronic alcoholism is poor.

关 键 词：慢性酒精中毒 脑桥中央髓鞘溶解 电解质紊乱 治疗预后 

分 类 号：R744.5[医药卫生—神经病学与精神病学]