小儿急性脊髓炎临床疾病过程与预后相关因素的分析  

Clinical features and prognostic factors of acute transverse myelitis in children

作　　者：蔡嘉琳[1] 吴洁[1] 鲍克容[1] 

机构地区：[1]上海第二医科大学附属新华医院小儿神经内科,200092

出　　处：《中国实用儿科杂志》2005年第1期35-37,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的　通过对 16例急性脊髓炎病例的分析、总结 ,进一步了解该病的临床特点及预后相关因素。方法　回顾1994年以来上海新华医院 16例小儿急性脊髓炎的临床资料、治疗结果 ,在部分病例随访的基础上 ,进行分析。结果　 16例患儿的主要临床表现有 :运动功能障碍 15例 (93 8% ) ,其中 13例 (86 7% )患儿仅表现为下肢运动功能障碍 ,2例伴上肢功能运动障碍且下肢症状重于上肢。在 16例患儿中 80 %是以运动功能障碍为首发症状。感觉功能障碍占 5 6 3% (9/ 16 ) ,括约肌功能障碍占 87 5 %。与预后不良相关的因素有 :临床表现有脊髓休克 (P =0 0 0 75 2 )、完全性截瘫 (P =0 0 38)、初期短于 9h(P =0 0 38)、极期≥ 10d(P =0 0 38) ;与预后不良无相关的因素有 :年龄、性别、临床表现有发热、疼痛及脑脊液异常。结论　对于那些具有不良预后因素的患儿 ,应进行积极干预 ,以期达到最佳恢复状态。Objective To identity clinical features of acute transverse myelitis in children and prognostic factors.Methods The data of 16 children with acute transverse myelitis was analyzed retrospectively.Results The main clinical symptoms were motor loss (93 8%) which was consistently involved and was severe in lower limbs.Motor deficit were present initially in 80% of the patients.Sensory dysfunction (56 3%) and sphincter dysfunction (87 50%).Factors associated with unfavorable outcome were spinal shock (P=0 00752),complete paraplegia (P=0 038),a time to maximal deficit shorter than 9 hours (P=0 038),plateau time longer than 10 days (P=0 038).There was no association between the factors of unfavorable outcome and age,sex,the present of fever and pain,abnormalities of cerebrospinal fluid.Conclusion Patients with the unfavorable outcome factors should be treated positively to improve the outcome.

关 键 词：儿童 急性脊髓炎 临床表现 预后 

分 类 号：R72[医药卫生—儿科]