小儿病毒性脑炎近期预后的预警因素分析  

Predictive factors of short-term neurological outcome in children with acute viral encephalitis

作　　者：宋小青[1] 王治平[2] 

机构地区：[1]上海第二医科大学附属新华医院儿内科,200092 [2]上海第二医科大学附属上海儿童医学中心特诊部,200127

出　　处：《中国实用儿科杂志》2004年第7期409-411,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的　回顾性分析小儿病毒性脑炎的临床资料 ,探讨影响近期预后的预警因素。方法　对 1997～ 2 0 0 3年上海第二医科大学附属新华医院收治的 10 1例病毒性脑炎患儿的临床表现及实验室检查进行回顾性分析 ,对近期预后进行评估 ,采用SPSS 10 0统计软件分析 ,寻找可能的预警因素。结果　近期预后差的患儿意识障碍持续时间、发热时间、惊厥发作时间均明显长于预后好的患儿 ( P <0 0 1)。预后差的患儿入院时多伴有惊厥 ( P <0 0 1) ,肢体运动障碍 (P <0 0 1) ,颅神经麻痹 (P <0 0 1)及其他脏器功能损害 (P <0 0 1)。其中 ,间歇性惊厥发作时间 (OR值 9 35 7,P =0 0 0 2 )是影响近期预后的重要临床预警因素。近期预后差的患儿脑脊液白细胞数低于预后好的 (P <0 0 1) ,脑电图高度异常的比例高 (P <0 0 1) ,脑电图恢复正常较慢 (P <0 0 1) ,多伴有影像学异常 (P <0 0 1)及低钠血症 (P <0 0 1)。其中 ,脑电图恢复慢是近期预后差的实验室预警因素。结论　小儿病毒性脑炎近期预后差的预警因素是惊厥发作时间长。Objective To retrospectively analyze the clinical data of children with acute viral encephalitis,and to make research on predictive factors of short term neurological outcome.Methods Medical records of 101 children with acute viral encephalitis were reviewed.Short term neurological outcome was assessed.Results There are significant differences in the time of impaired consciousness,fever,seizures (P<0 01) between poor and good short term outcome.Seizures (P<0 01),motor weakness (P<0 01),cranial nerve deficits (P<0 01) and dysfunction of other organs (P<0 01) were present at admission in children with poor short term outcome.A long history of having seizures (odds risk:9 357,P<0 01) was an important factor that predicted a poor short term outcome in clinical signs.Abnormal cerebrospinal fluid (P<0 01),the percentage of high abnormal electroencephalogram (P<0 01),slow recovery to normal electroencephalogram (P<0 01),neuroimaging changes (P<0 01) and hyponatremia (P<0 01) were present frequently in children with poor short term outcome.Slow recovery to normal electroencephalogram (odds risk:1 343,P=0 007) was the factor that predicted a poor short term outcome in laboratory parameters.Conclusion A long history of having seizures and slow recover to normal electroencephalogram are the predictive factors that correlate with poor short term neurological outcome.

关 键 词：近期预后 脑炎 病毒性 儿童 

分 类 号：R72[医药卫生—儿科]