王昊 林松

    [摘要] 目的 探讨神经外科术后丙戊酸钠导致的高血氨性高血氨性脑病病例的临床特点。 方法 总结天坛医院神经外科2013年10月～2015年3月收治的7例高血氨性脑病患者，重点汇报2例典型病例；分析患者的临床表现及实验室检查；总结神经外科术后高血氨性脑病的共同点，并提出预防和治疗该病的合理方案。 结果 高血氨性脑病的症状包括谵妄、嗜睡、昏睡、昏迷、癫痫等；血氨升高是特征性实验室检查；停用丙戊酸钠是最有效的治疗方法。 结论 在神经外科，高血氨性脑病是极其少见的并发症，可能导致严重后果；合理使用丙戊酸钠非常关键；使用丙戊酸钠预防癫痫的患者应监测血氨水平；当患者的意识状态无法用神经外科原发病解释，且实验室检查提示血氨升高，应该及时停药。早期诊断，该病预后良好。

    [关键词] 丙戊酸钠；高血氨性脑病；神经外科

    [中图分类号] R971.6 [文献标识码] A [文章编号] 1673-7210(2015)08(c)-0146-04

    [Abstract] Objective To discuss the clinical features of Valproate-induced hyperammonemic encephalopathy after neurosurgery operation. Methods Seven case with Valproate-induced hyperammonemic encephalopathy in Department of Neurosurgery， Beijing Tiantan Hospital， Capital Medical University were reviewed. Two cases were described in detail. The characteristics of clinical manifestations and laboratory examinations were retrospectively analyzed. The common features of these cases were summarized and a standard method to prevent and treat Valproate-induced hyperammonemic encephalopathy was presented. Results The symptoms of Valproate-induced hyperammonemic encephalopathy included delirium ......