| 张朋,赵智亨,程明,等.颅内低压综合征合并新型冠状病毒感染 12例临床分析[J].安徽医药,2024,28(12):2502-2507. |
| 颅内低压综合征合并新型冠状病毒感染 12例临床分析 |
| Clinical analysis of 12 cases of intracranial hypotension syndrome complicated with novel coronavirus pneumonia |
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| DOI：10.3969/j.issn.1009-6469.2024.12.034 |
| 中文关键词: 颅内低压 新型冠状病毒感染 脑静脉 颅内血栓形成 癫痫发作 |
| 英文关键词: Intracranial hypotension Novel coronavirus pneumonia Cerebral veins Intracranial thrombosis Seizures |
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| 中文摘要: |
| 目的探讨、总结颅内低压综合征(IHS)合并新型冠状病毒(新冠病毒)感染的病例特点。方法回顾性分析 2022年 10月至 2023年 2月在解放军海军第九七一医院、解放军联勤保障部队第九六〇医院及胜利油田中心医院住院治疗的 12例 IHS合并新冠病毒感染病人的临床、检验及影像学等资料。结果 12例病人中 9例为 IHS病程中合并新冠病毒感染， 3例为新冠病毒感染后合并 IHS。9例因 IHS起病者中，轻型感染 4例，中型感染 4例，重型感染 1例，合并感染后出现头痛加重或头痛性质者改变 7例，嗅觉下降 1例，肌肉疼痛 2例，肢体乏力 4例，记忆力减退加重 1例。 3例因新冠病毒感染起病者中，轻型感染 1例，中型感染 2例， 3例均在治疗过程中出现头痛症状在直立位后明显加重的表现。 12例病人中有 6例纤维蛋白原升高， 5例 D-二聚体升高， 5例白细胞介素 -6升高，均系在新冠病毒感染后出现。 3例在病程中合并脑静脉血栓形成( CVT)，分别累及上矢状窦、右侧中央后静脉和右侧横窦及乙状窦，其中 2例出现症状性癫痫。 12例病人除 1例遗留记忆力减低，其余病人预后良好。结论合并新冠病毒感染可使 IHS症状复杂化，给予心理疏导可能会减少 IHS合并新冠病毒感染病人认知障碍的发生。 IHS合并新冠病毒感染可能会增加 CVT的发病率，应注意监测 D-二聚体、纤维蛋白原、白细胞介素 -6等指标，高龄、凝血障碍病人预防性使用抗凝治疗可能会降低 CVT发生风险。 |
| 英文摘要: |
| Objective To explore and summarize the characteristics of intracranial hypotension syndrome (IHS) complicated withnovel coronavirus pneumonia.Methods The clinical, laboratory and imaging data of 12 patients with IHS complicated with novel coro-navirus pneumonia who were hospitalized in The 971th Hospital of PLA Navy, The 960th Hospital of the Joint Logistics Support Forceof PLA and Shengli Oilfield Central Hospital from October 2022 to February 2023 were analyzed retrospectively.Results Among the12 patients, 9 cases were complicated with novel coronavirus pneumonia during the course of IHS, and 3 cases were complicated withIHS after novel coronavirus pneumonia. Among the 9 patients who started with IHS, 4 cases were mild infection, 4 cases were moderateinfection, 1 case was severe infection. After complicated infection, 7 cases had headache aggravation or property change, 1 case had de-creased smell, 2 cases had muscle pain, 4 cases had limb weakness, and 1 case had decreased memory. Among the 3 patients who start-ed with novel coronavirus pneumonia, 1 case had mild infection and 2 cases had moderate infection. All 3 cases had headache symp-toms that were significantly aggravated after standing upright during the treatment. Among the 12 patients, fibrinogen increased in 6cases, D-dimer increased in 5 cases, and interleukin-6 increased in 5 cases, all of which occurred after novel coronavirus pneumonia.Three cases were complicated with cerebral venous thrombosis (CVT) during the course of the disease, involving the superior sagittal si-nus, right posterior central vein, and right transverse and sigmoid sinuses, respectively. Among them, 2 cases developed symptomaticepilepsy. The prognosis of the 12 patients was good, except for 1 patient with residual memory impairment.Conclusions Co-infection with SARS-CoV-2 can complicate the symptoms of IHS, and psychological counseling may reduce the occurrence of cognitive impair-ment in patients with novel coronavirus pneumonia. IHS combined with novel coronavirus pneumonia may increase the incidence rate of CVT. Attention should be paid to the monitoring the indicators of D-dimer, fibrinogen, interleukin-6. The prophylactic use of antico-agulant therapy in elderly patients with coagulation disorders may reduce the risk of CVT. |
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