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一名13岁有症状性癫痫男孩发生神经源性肺水肿——病例报告

Neurogenic pulmonary oedema in a 13-year-old boy in the course of symptomatic epilepsy--case report.

作者信息

Wasowska-Królikowska K, Krogulska A, Modzelewska-Hołyńska M

机构信息

Department of Gastroenterology and Paediatric Allergology, Institute of Paediatrics, Medical University, ul. Sporna 36/50, 91-738 Łódź, Poland.

出版信息

Med Sci Monit. 2000 Sep-Oct;6(5):1003-7.

Abstract

Pulmonary oedema with severe, dramatic course following CNS injury was termed neurogenic pulmonary oedema (NPO). NPO was mainly described as a consequence of grand mal seizures, subarachnoid bleeding, intracranial bleeding or head injury. However, the pathogenesis of NPO is not entirely clear yet. In the majority of cases, early or classic symptoms of pulmonary oedema are evident from several minutes up to several hours after CNS damage. Dyspnoea, chest pain, bloody expectoration are observed shortly after consciousness disorders, although NPO may occasionally be diagnosed on the basis of chest x-ray in patients with no clinical symptoms. Tachypnoea, tachycardia, rales without any changes in cardiac system are usually observed during physical examination. The ailments withdraw quickly in the majority of patients, who may require oxygen therapy at most. NPO has been well-known in adults, but our knowledge of its occurrence in children is still rather sparse. The current work presents a case of a 13-year-old boy with pulmonary oedema as a post-seizure complication.

摘要

中枢神经系统损伤后病程严重且急剧的肺水肿被称为神经源性肺水肿(NPO)。NPO主要被描述为癫痫大发作、蛛网膜下腔出血、颅内出血或头部损伤的后果。然而,NPO的发病机制尚不完全清楚。在大多数情况下,肺水肿的早期或典型症状在中枢神经系统损伤后的几分钟至几小时内就很明显。意识障碍后不久会出现呼吸困难、胸痛、咯血,尽管NPO偶尔也可在无临床症状的患者中通过胸部X线检查确诊。体格检查时通常会观察到呼吸急促、心动过速、肺部啰音而心脏系统无任何变化。大多数患者的症状会迅速消退,这些患者最多可能需要吸氧治疗。NPO在成人中已广为人知,但我们对其在儿童中的发生情况了解仍然相当稀少。目前的研究报告了一例13岁男孩发生肺水肿作为癫痫发作后并发症的病例。

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