在整体胃切除术后的患者的骨科康复期间的非酒精维尼克脑病:一个病例报告

Shunsuke Ota¹, Yoshihisa Fujinami¹, Keiji Sato¹

¹Department of Emergency Medicine, Kakogawa Central City Hospital, Kakogawa, JPN.

Cureus

|October 27, 2025

概括

沃尼克脑病变 (WE) 可能发生在有胃肠道手术史的老年患者中,即使没有使用酒精. 慢性胺吸收不良,由摄入不良引发,可以导致这种情况.

科学领域:

神经学神经学
营养科学营养科学
老年病的医生老年病的医生

背景情况:

沃尼克脑病 (Wernicke encephalopathy,简称WE) 是一种严重的神经疾病,通常与慢性酒精滥用有关.
胃肠道手术,如全胃切除术,可能导致长期的吸收不良问题,包括胺缺乏症.
患有并发症和最近功能衰退的老年人患营养缺乏症的风险增加.

研究的目的:

为了突出一个病例的韦尼克脑病变在一个老年患者的病史的全胃切除.
强调在有胃肠道手术病史的患者中考虑WE的重要性,而不管他们是否饮酒.
为了说明慢性胺吸收不良和急性营养缺乏在WE发病中的作用.

主要方法:

一个82岁的女性病人的病例报告显示精神状态变化和虚弱.
诊断工作包括脑MRI (FLAIR) 和血清胺水平测量.
治疗包括静脉注射胺和水合治疗.

主要成果:

大脑MRI揭示了中脑水道和中部骨中特有的高信号强度.
血清胺水平显著低 (1.2μg/dL).
患者的精神状况在胺治疗和支持性护理后显著改善.

结论:

经过全胃切除术后的慢性胺吸收不良被确定为WE的潜在原因.
由于口服摄入不良而导致的急性营养缺乏症,在一个胺储量枯竭的患者中导致了WE.
这一案例强调了在老年患者中怀疑WE的必要性,这些患者具有风险因素,如先前的胃肠道手术,即使没有酒精使用史.

关键词:

年长的老年人年长的老年人胃切除术是一种胃切除术.没有酒精的温尼克脑病变 (Wernicke encephalopathy)胺缺乏症胺缺乏症维尼克脑病变 (Wernicke encephalopathy) 是一种脑病变.

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