早发型重度子痫前期合并可逆性后部白质脑病综合征30例临床分析

摘要

Objective To investigate the clinical manifestations, CT imaging features and prognosis of early onset severe preeclampsia with reversible posterior leukoencephalopathy syndrome(RPLS). Methods 30 cases of early onset severe preeclampsia combined with RPLS in the hospital were analyzed retrospectively. Results Acute episode of headache and visual disturbance was observed in all patients. In CT scanning, all patients were found with focal low density changes, 21 locating in bilateral parieto-occipital areas, 9 locating in parrelled focal low density changes. After active and timely treatment, all patients returned to normal in clinical and radiological features. Conclusion Headache and blurred vision were the primary manifestations of early onset severe preeclampsia with RPLS, early diagnosis and proper treatment may improve the prognoses of patients, and prevent cerebral vascular accident.%　　目的探讨早发型重度子痫前期合并可逆性后部白质脑病综合征（RPLS）的临床表现、CT 影像与预后情况。方法回顾性分析2005年1月至2012年12月安阳市妇幼保健院收治早发型重度子痫前期合并 RPLS 30例临床资料。结果30例均表现为急性发作的头痛和视物模糊。头颅 CT 检查21例表现为两侧对称分布的累及顶枕叶的片状低密度灶，9例表现为累及一侧的顶枕叶片状低密度灶。治疗后，所有患者的临床表现及影像学检查均恢复正常。结论头痛和视物模糊是早发型重度子痫前期合并 RPLS 的主要临床表现，早诊断、正确治疗，可改善孕产妇预后，防止脑血管意外的发生。