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低渗性脑病是一继发病,其表现无特异性,因此易被误诊。现将近6年来所遇到的16例低渗性脑病误诊情况分析如下。1临床资料1.1 一般资料:16例为急诊观察和住院患者。其中男12例.女4例.年龄49～72岁,平均58.1岁。1.2原发病及误诊疾病:8例肺心病患者误诊为肺性脑病;4例肝硬化患者误诊为肝性疾病;2例风心病误诊为脑栓塞;2例缺血性心肌病误诊为心源性休克。1.3临床表现及化验检查:16例除有原发性疾病表现外均有程度不同的精神症状。其中表情淡漠、神志模糊8例,嗜睡4例,烦躁、谵语2例,休克昏迷2例,血钠均<125mmol/L,血渗透压260～240mosm/L5例,239～220mosm/L 6例.<220mosm/L 5例。1.4 诊断标准:16例低渗性脑病均按下述条件诊断:①有低渗性脑病的诱因。②有低渗性脑病临床表现。③血钠<125mmool/L,血渗透压<260mosm/L。④除外其它脑病如肺性、肝性、肾性、胰性及各种感染性脑病。
Hypotonic encephalopathy is a secondary disease, its performance is not specific, so easily misdiagnosed. Now encountered in the past 6 years 16 cases of misdiagnosis of hypotonic encephalopathy situation is as follows. 1 Clinical data 1.1 General information: 16 cases of emergency observation and hospitalized patients. Including 12 males and 4 females, aged 49 to 72 years, mean 58.1 years old. 1.2 primary and misdiagnosed diseases: 8 cases of pulmonary heart disease misdiagnosed as pulmonary encephalopathy; 4 cases of liver cirrhosis misdiagnosed as liver disease; 2 cases of rheumatic heart disease misdiagnosed as cerebral embolism; 2 cases of ischemic cardiomyopathy misdiagnosed as heart Sexual shock. 1.3 clinical manifestations and laboratory tests: 16 cases except for the performance of primary disease have different degrees of mental symptoms. Among them, the expressions were indifferent, confusion in 8 cases, drowsiness in 4 cases, irritability, delirium in 2 cases, shock coma in 2 cases, serum sodium were <125mmol / L, blood osmolality 260 ~ 240mosm / L 5 cases, 239 ~ 220mosm / L 6 cases. <220mosm / L 5 cases. 1.4 diagnostic criteria: 16 cases of hypotonic encephalopathy diagnosis by the following conditions: ① hypotensive encephalopathy incentives. ② hypotonic encephalopathy clinical manifestations. ③ blood sodium <125mmool / L, blood osmolarity <260mosm / L. ④ Except for other encephalopathy such as pulmonary, hepatic, renal, pancreatic and various infectious encephalopathy.