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中枢神经系原性过度换气(CNH)常见于因半球病变而昏迷的病人,而清醒患者罕见.本文报告一例清醒肿瘤患者中枢性过度换气的病例,并复习文献进行讨论.患者女性,72岁,因右侧肢体无力入院.体查发现:神志清楚,右侧偏瘫、感觉迟钝,全身反射亢进,尿失禁.CT扫描示双侧脑白质多个低密度病灶,脑血管造影无异常.初诊为多发性脑梗塞.用低分子右旋糖酐和尿激酶治疗无效.一周后出现呼吸深快,且于睡眠时持续存在.动脉血气分析提示低碳酸血症、轻度高氧血症和明显的呼吸性碱中毒.胸片和超声心动图无异常,腰穿脑脊液检查发现淋巴细胞和蛋白轻度增高.经治疗无效患
Central nervous system hyperventilation (CNH) is common in patients with coma due to hemispheric lesions, and rare in awake patients. This article reports one case of central hyperventilation in patients with awake tumors and reviewed the literature for discussion. Patient female, 72 Years old, because the right limb was unable to hospital. Physical examination found: conscious, right hemiplegia, feeling dull, generalized hyperreflexia, urinary incontinence. CT scan showed multiple low density lesions of bilateral white matter, no abnormal cerebral angiography. For multiple cerebral infarction. Ineffective with low molecular weight dextran and urokinase therapy. Rapid breathing occurs after one week and persists during sleep. Arterial blood gas analysis suggests hypocapnia, mild hyperxemia, and apparent respiration. Alkali poisoning. Chest radiographs and echocardiography were not abnormal. Lumbar cerebrospinal fluid examination revealed mildly elevated lymphocytes and proteins.