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目的探讨脑桥外髓鞘溶解症的发病机制和治疗方法。方法分析3例脑桥外髓鞘溶解症患者的临床特点,包括诱发因素、临床表现、头颅MRI特点、并发症、治疗措施及预后情况等。结果 3例患者均在快速纠正的低钠血症后出现意识障碍,合并有严重肺部感染,头颅MRI示基底节区对称性T1WI低信号,T2WI、Flair、DWI高信号病灶,预后均不佳。结论过快纠正低钠血症和感染是脑桥外髓鞘溶解症的危险因素,降低升高过快的血钠水平能改善病情,有机渗透物是参与发病的重要因素,但其防治作用还有待于临床研究的进一步验证。
Objective To investigate the pathogenesis and treatment of myelinolysis outside the pontine. Methods The clinical features of 3 patients with myelinolysis, including the predisposing factors, clinical manifestations, cranial MRI features, complications, treatment measures and prognosis were analyzed. Results All 3 patients had unconsciousness after rapid correction of hyponatremia with severe pulmonary infection. MRI showed basal ganglia symmetry T1WI low signal, T2WI, Flair and DWI high signal lesions with poor prognosis . Conclusions To correct hyponatremia and infection too fast is a risk factor for myelinolysis in pontine. To reduce the excessively high serum sodium level can improve the condition. Organic permeable substance is an important factor involved in the pathogenesis, but its preventive and therapeutic effect remains to be determined Further validation in clinical studies.