恙虫病伴严重头痛12例临床分析

摘要

目的探讨恙虫病伴严重头痛时的治疗。方法对10年来12例恙虫病伴严重头痛患者的临床资料进行回顾性总结分析,了解恙虫病伴严重头痛时头颅磁共振表现、颅内压、脑脊液。结果6例存在轻度脑组织肿胀,7例颅内压升高,3例脑脊液轻度异常,12例均给予甘油果糖或联合甘露醇脱水治疗,头痛均明显改善,明确诊断后,在有效抗感染的情况下,酌情给予应用地塞米松,头痛均缓解。结论恙虫病伴头痛,多提示合并颅内损害,行头颅磁共振检查、颅内压测定,脑脊液检查,有助于评估病情,给予甘油果糖或联合甘露醇,以及在有效抗感染的情况下,酌情给予地塞米松,有助于改善患者头痛。%　　Objective To explore the treatment of Scrub typhus with severe headache. Methods Retrospectively analyzed and summarized. clinical datas of 12 cases patients diagnosed scrub typhus with severe headache for 10 years in our hospital inpatients. Understand the head MRI features, intracranial pressure, and cerebrospinal fluid changes of scrub typhus with severe headache. Results 6 cases of patients with mild brain tissue swelling,7 cases of patients with elevated intracranial pressure,3 cases cerebrospinal fluids mild exceptionally,12 patients were given glycerol fructose or combined with mannitol dehydration treatment, headache improved significantly. After diagnosis, in the case of effective anti-infective, as appropriate, given dexamethasone, headaches were relieved. Conclusion Scrub typhus with headache, what prompted with intracranial injury, head MRI, measurement of intracranial pressure, cerebrospinal fluid examinations, contribute to the assessment of disease severity, giving glycerol fructose or combined with mannitol. After diagnosis, in the case of effective anti-infective, give appropriate dexamethasone, contributes to improve the headache.