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目的探讨带状疱疹性脊髓炎的临床特点、诊断及治疗。方法对4例带状疱疹性脊髓炎患者的临床资料进行回顾性分析。结果 4例患者均有特征性皮疹及脊髓损害症状。3例以皮疹为首发,1例以脊髓节段性损害症状首发,3例表现为对称性或非对称性双下肢无力和感觉障碍,1例表现为一侧肢体麻木、抽搐,无肢体瘫痪,3例有括约肌障碍。均经脊髓MR证实,均行脑脊液检查,抗病毒及甲强龙治疗效果好,随访1年以上3例痊愈,1例留有双下肢轻瘫。结论脊髓炎是带状疱疹的少见并发症,多累及胸髓,少数累及颈髓,多表现为脊髓不完全性横贯性损害,症状多不对称,早期诊断及抗病毒和甾体类激素治疗效果好。
Objective To study the clinical features, diagnosis and treatment of herpes zoster myelitis. Methods The clinical data of 4 patients with herpes zosteritis were retrospectively analyzed. Results 4 patients had characteristic rashes and spinal cord injury symptoms. 3 cases with rash as the first episode, 1 case with spinal cord lesion onset, 3 cases showed symmetry or asymmetry of lower extremity weakness and sensory disturbances, 1 case showed side limb numbness, convulsions, no limb paralysis, Three patients had sphincter disorders. Both confirmed by spinal MR, cerebrospinal fluid were performed, anti-virus and methylprednisolone treatment effect, follow-up more than 1 year 3 cases recovered, 1 case left lower extremity paresis. Conclusions Myelitis is a rare complication of shingles, involving more in the thoracic cavity and a few of the cervical spinal cord. It is characterized by incomplete transverse spinal cord injury, asymmetric symptoms, early diagnosis, and anti-viral and steroid hormone treatment it is good.