12例抗NMDA受体脑炎的临床资料分析和护理体会

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摘要目的研究12例抗N-甲基-D天门冬氨酸（NMDA）受体脑炎患者的临床特点和护理原则。方法回顾性分析2017年2月～2018年2月四川大学华西医院神经内科收治的抗NMDA受体脑炎患者12例，均给予针对性的治疗及护理方法，分析患者的一般资料、辅助检查、治疗及转归。结果脑电图检查结果示2例弥漫性慢波，7例额颞区的中高幅慢波，1例痫样放电；脑脊液检查示4例压力增高，10例细胞数增多，7例脑脊液压力增高；MRI检查示4例头部异常信号；腹部影像学检查示3例畸胎瘤。入院后均接受激素冲击及丙种球蛋白疗法。1例患者出院2个月后死亡，其余均好转。结论抗NMDA受体脑炎的治疗药物多选择激素治疗和免疫球蛋白输注，护理工作应注意患者可能出现的危险并进行针对性护理。

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	龙泽芳黎恩知陈德智

关键词 ：抗N-甲基-M-天冬氨酸受体抗体, 脑炎, 癫痫, 护理

Abstract：Objective To study the clinical characteristics and nursing principles of 12 patients of N-methyl-D-aspartate (NMDA) receptor encephalitis. Methods From February 2017 to February 2018, 12 patients with anti-NMDA receptor encephalitis admitted to the Department of Neurology, West China Hospital of Sichuan University were retrospectively analyzed. All cases were given targeted treatment and nursing methods, the general information, auxiliary examination, treatment and outcome of the patients were analyzed. Results The results of electroen cephalogram showed that, 2 cases of diffuse slow wave, 7 cases of middle and high amplitude slow wave in frontotemporal area, 1 case of epileptiform discharge; cerebrospinal fluid examination showed 4 cases of increased pressure, 10 cases of increased cell number, 7 cases of increased cerebrospinal fluid pressure; Magnetic resonance imagine examination showed 4 cases of abnormal signals in the head; abdominal imaging showed 3 cases of teratoma. All patients received hormone shock and gamma globulin therapy after admission. One case died 2 months after discharge, the other were improved. Conclusion The treatment of anti-NMDA receptor encephalitis is hormone therapy and immunoglobulin infusion, nursing work should pay attention to the possible risk of patients and carry out targeted care.

Key words： N-methyl-D-aspartate receptor antibody Encephalitis Epilepsy Nursing care

基金资助:四川省卫生和计划生育委员会科研课题（18PJ2 68）。

引用本文:

龙泽芳黎恩知陈德智. 12例抗NMDA受体脑炎的临床资料分析和护理体会[J]. 中国医药导报, 2020, 17(14): 182-185.
LONG Zefang LI Enzhi CHEN Dezhi. Clinical data analysis and nursing experience of 12 cases of anti - NMDA receptor encephalitis. 中国医药导报, 2020, 17(14): 182-185.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I14/182

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