国际妇产科学杂志 ›› 2024, Vol. 51 ›› Issue (2): 194-197.doi: 10.12280/gjfckx.20230827

• 产科生理及产科疾病:病例报告 • 上一篇    下一篇

妊娠剧吐合并韦尼克脑病一例

姜龙环, 褚春玉, 张营, 朱彤宇()   

  1. 261053 潍坊医学院临床医学院(姜龙环,褚春玉);中国人民解放军联勤保障部队第九六医院妇产科(张营,朱彤宇)
  • 收稿日期:2023-10-20 出版日期:2024-04-15 发布日期:2024-04-19
  • 通讯作者: 朱彤宇,E-mail:ZTY6812@163.com

A Case Report of Hyperemesis Gravidarum Combined with Wernicke Encephalopathy

JIANG Long-huan, CHU Chun-yu, ZHANG Ying, ZHU Tong-yu()   

  1. School of Clinical Medicine, Weifang Medical University, Weifang 261053, Shandong Province, China (JIANG Long-huan, CHU Chun-yu); Department of Obstetrics and Gynecology, No.960 Hospital of the Joint Logistics Support Force of the Chinese People′s Liberation Army, Jinan 250031, China (ZHANG Ying, ZHU Tong-yu)
  • Received:2023-10-20 Published:2024-04-15 Online:2024-04-19
  • Contact: ZHU Tong-yu, E-mail: ZTY6812@163.com

摘要:

妊娠剧吐是在妊娠期间出现严重恶心和呕吐的病症,可引起多种并发症,如脱水、酸中毒等体液和电解质代谢紊乱,以及顽固性呕吐引起的并发症,如食管撕裂和消化道出血等,其中死亡风险较高的是韦尼克脑病,若诊断及治疗不及时会引起严重后果。报道1例妊娠剧吐合并韦尼克脑病孕妇,该患者伴有恶心、呕吐、头晕和眼球震颤等典型的韦尼克脑病临床症状,但尚未出现典型影像学表现,入院时即常规给予100 mg维生素B1肌内注射,确诊后及时给予大剂量维生素B1并终止妊娠后,症状好转并未遗留并发症。提示妊娠剧吐合并韦尼克脑病的影像学异常通常具有滞后性,对于出现相关症状和疑似诊断应立即补充维生素B1

关键词: 韦尼克脑病, 妊娠剧吐, 硫胺素, 磁共振成像, 病例报告

Abstract:

Hyperemesis gravidarum is a condition characterized by severe nausea and vomiting during pregnancy, which can cause various complications, such as dehydration, acidosis and other disorders of fluid and electrolyte metabolism, as well as complications caused by intractable vomiting, such as esophageal laceration and gastrointestinal hemorrhage, etc. Among them, the one with the higher risk of death is Wernicke encephalopathy, which can lead to serious consequences if the diagnosis and treatment are not timely. A case of pregnant woman with hyperemesis gravidarum and Wernicke encephalopathy was reported. The patient presented with typical clinical symptoms of Wernicke encephalopathy such as nausea, vomiting, dizziness and nystagmus, but did not show typical imaging manifestations. Upon admission, a routine intramuscular injection of 100 mg vitamin B1 was administered. After diagnosis, high-dose vitamin B1 was given timely and termination of pregnancy. The symptoms improved and no residual complications. This case suggests that the imaging abnormalities of Wernicke encephalopathy combined with hyperemesis gravidarum have a lagging effect, and that vitamin B1 supplementation should be given immediately for the appearance of relevant symptoms and suspected diagnosis.

Key words: Wernicke encephalopathy, Hyperemesis gravidarum, Thiamine, Magnetic resonance imaging, Case reports