一名孕妇脑损伤后出现难治性阵发性交感神经过度兴奋，产后症状显著改善。
Refractory paroxysmal sympathetic hyperactivity following brain injury in a pregnant woman that dramatically improved after delivery.
作者信息
Inoue Akira, Ebina Masatomo, Atsumi Takahiro, Ariyoshi Koichi
机构信息
Department of Emergency Medicine Kobe City Medical Center General Hospital Kobe Japan.
Department of Emergency Medicine Seirei Hamamatsu General Hospital Shizuoka Japan.
出版信息
Acute Med Surg. 2015 Dec 8;3(3):268-271. doi: 10.1002/ams2.180. eCollection 2016 Jul.
CASE
A 16-year-old primiparous girl in the 11th week of gestation presented to our hospital with a traumatic brain injury suffered during a motorcycle accident. She was comatose on arrival to the hospital and was admitted to the intensive care unit. From day 2, she developed intermittent episodes of tachycardia with tachypnea, fever, profuse sweating, and extensor posturing. She was diagnosed with paroxysmal sympathetic hyperactivity (PSH) and treated with morphine. However, paroxysmal sympathetic hyperactivity could not be controlled and her general condition deteriorated. Intrauterine fetal death was confirmed in the 16th week of gestation, on day 37 of hospitalization. P paroxysmal sympathetic hyperactivity increased each day until delivery and dramatically improved after delivery.
OUTCOME
The patient gradually regained consciousness and was discharged to a rehabilitation hospital on day 117 after hospitalization.
CONCLUSION
Pregnancy is a risk factor for paroxysmal sympathetic hyperactivity exacerbation, and delivery can result in resolution of the condition.
病例
一名16岁初产妇，孕11周，因摩托车事故导致颅脑损伤前来我院就诊。入院时昏迷，被收入重症监护病房。从第2天起，她出现间歇性心动过速伴呼吸急促、发热、大汗淋漓及伸肌强直。她被诊断为阵发性交感神经过度兴奋（PSH），并接受吗啡治疗。然而，阵发性交感神经过度兴奋无法得到控制，她的一般状况恶化。住院第37天，孕16周时确诊为宫内胎儿死亡。阵发性交感神经过度兴奋在分娩前每天加重，分娩后显著改善。
结果
患者逐渐恢复意识，住院117天后出院，转至康复医院。
结论
妊娠是阵发性交感神经过度兴奋加重的危险因素，分娩可使病情缓解。
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