| 摘要: |
| [摘要]目的：探讨以中枢神经系统受累为首发表现的山豆根中毒患儿的临床特征及诊疗方案，为临床安全用药提供参考。方法：回顾性分析2014年1月至2019年1月西安交通大学第一附属医院收治的3例以中枢神经系统受累为首发表现的山豆根中毒患儿的临床资料。结果：3例患儿均以步态不稳、四肢无力为首发症状。2例合并意识障碍（嗜睡）及构音障碍，1例合并视物模糊。头颅影像学主要表现为小脑齿状核及局部白质异常信号。治疗上除常规急性中毒救治原则外，部分病例还予糖皮质激素或人免疫球蛋白抑制免疫反应治疗。2例患儿预后良好，1例患儿遗留神经系统后遗症。结论：山豆根中毒致中枢神经系统损害症状类似中枢神经系统感染表现，注意避免误诊，其神经损害主要为脱髓鞘改变，免疫抑制治疗有一定疗效。山豆根规范用药需要多方面共同监督。 |
| 关键词: 山豆根 中毒 儿童 中枢神经系统损害 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2022.10.007 |
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| 基金项目:陕西省社会发展科技攻关项目,编号2015SF129;陕西省重点研发计划项目,编号2018SF096。 |
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| Clinical Analysis on 3 Cases of Subprostrate Sophora Poisoning in Children with Central Nervous System Involvement as the First Manifestation |
| Ning Ping1,2, Liu Xiaohong1 |
| (1. The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China; 2. Weinan Maternal and Child Health Care Hospital, Shaanxi Weinan 714000, China) |
| Abstract: |
| [Abstract] Objective: To explore the clinical characteristics, diagnosis and treatment of subprostrate sophora poisoning in children with central nervous system involvement as the first manifestation, so as to provide reference for clinical safe drug use. Methods: Retrospective analysis was performed on clinical data of 3 children with subprostrate sophora poisoning with central nervous system involvement as the first manifestation in the First Affiliated Hospital of Xi’an Jiaotong University from Jan. 2014 to Jan. 2019. Results: The first symptoms were instability of gait and limb weakness in 3 children. There were 2 cases with consciousness disorder (drowsiness) and dysarthria, and 1 case with blurred vision. The main manifestations of cranial imaging were cerebellar dentate nucleus and local white matter abnormal signals. In addition to the principle of routine treatment for acute poisoning, some cases were treated with glucocorticoid or human immunoglobulin to suppress immune response. Two cases had good prognosis and one case had neurological sequelae. Conclusion: The symptoms of central nervous system damage induced by subprostrate sophora poisoning are similar to those of central nervous system infection, and misdiagnosis should be avoided. The main nerve damage is demyelination, and immunosuppressive therapy has a certain effect. Standardized medication of subprostrate sophora needs joint supervision from many aspects. |
| Key words: subprostrate sophora poisoning children central nervous system damage |
