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脑干出血偶尔伴发高热,但死亡常常是严重脑干损伤的结果,而不是高热。作者报道2例脑干出血病例,以严重高热、横纹肌溶解、急性肾衰和迅速致死病程为特征(作者将之定义为恶性脑干高热)。 例1,男性,55岁,有高血压病史。患者洗澡后很快昏迷,格拉斯格昏迷评分为E_1V_1M_3,病人体温40.2℃,血压246/140mmHg,血清肌酸磷酸激酶(Cpk)指标为233IU/L,CT扫描示有一血肿从桥脑被盖部延至中脑,伴有脑积水。应用硝酸甘油等药物控制血压,潘冠罗宁控制寒战,行气管插管,右侧脑室引流术,但病情没有改观。病程第1天上午,Cpk指标为2663IU/L。当天8pm始发生胃肠道出血、鼻出血、DIC及尿闭。病程第2天晚CpK指标升到205400IU/L。尽管极力支持治疗,患者仍
Brainstem haemorrhage occasionally carries high fever, but death is often the result of severe brain stem injury, not hyperthermia. The authors report two cases of bleeding from the stem of the brain stem, characterized by severe hyperthermia, rhabdomyolysis, acute renal failure, and rapid lethality (which the authors define as malignant brainstem hyperthermia). Example 1, male, 55 years old, with a history of hypertension. The patient was comatose immediately after bathing. The score of Grasig's coma was E_1V_1M_3, the temperature of the patient was 40.2 ℃, the blood pressure was 246/140 mmHg, the serum creatine kinase (Cpk) was 233IU / L, CT scan showed a hematoma from the pons Delayed to the brain, accompanied by hydrocephalus. Application of nitroglycerin and other drugs to control blood pressure, Pan Guan Ronin control chills, tracheal intubation, right ventricular drainage, but the disease did not change. On the first day of the course of the disease, the Cpk index was 2663 IU / L. Gastrointestinal bleeding, nasal bleeding, DIC, and urinary closure occurred at 8pm the same day. The second day of the course of CpK index rose to 205400IU / L. Despite strong support for treatment, the patient remains