高压氧对小儿重症病毒性脑炎的临床疗效及预后的影响  

Effects of hyperbaric oxygen on the clinical efficacy and prognosis of severe viral encephalitis in children

作　　者：陈满秋[1] 杨春凤[2] 郭洵[1] 李玉梅[2] Chen Manqiu;Yang Chunfeng;Guo Xun;Li Yumei(Department of Hyperbaric Oxygen,The First Hospital of Jilin University,Changchun 130021,China)

机构地区：[1]吉林大学第一医院高压氧科,长春130021 [2]吉林大学第一医院小儿ICU科,长春130021

出　　处：《中华航海医学与高气压医学杂志》2021年第5期602-606,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨高压氧治疗对小儿重症病毒性脑炎的临床疗效及预后的影响。方法回顾性分析2013年1月至2017年12月在吉林大学第一医院PICU诊治的83例小儿重症病毒性脑炎患儿的临床资料,按照治疗方法分为对照组(常规治疗,n=41)和治疗组(常规治疗联合高压氧治疗,n=42),治疗30 d后比较2组患儿临床效果,治疗组肢体瘫痪患儿高压氧治疗30 d后再与对照组肢体瘫痪患儿比较预后情况。结果治疗30 d后治疗组总有效率(85.4%)明显高于对照组(71.9%),差异有统计学意义(χ^(2)=7.114,P<0.05)。与对照组相比,治疗组患儿发热、抽搐、昏迷、谵妄、脑神经受累、脑膜刺激征的症状及体征恢复得更早,差异均有统计学意义(P<0.05)。治疗组肢体瘫痪患儿的肢体功能评分明显高于对照组,差异有统计学意义(P<0.05)。治疗组的头部病灶好转率(86.5%)明显高于对照组(71.9%),差异有统计学意义(χ^(2)=6.138,P<0.05)。结论高压氧综合治疗可以改善小儿重症病毒性脑炎的临床症状和体征,并缩短其持续时间,头部病灶得到明显改善,肢体运动障碍的恢复明显加快,住院时间明显缩短。Objective To investigate the effects of hyperbaric oxygen therapy on the clinical efficacy and prognosis of severe viral encephalitis(VE)in children.Methods The clinical data of 83 children with severe VE treated in the Pediatric Intensive Care Unit(PICU)of the First Hospital of Jilin University from January 2013 to December 2017 were analyzed retrospectively.They were divided into two groups according to different treatment methods,namely control group(conventional treatment)and treatment group(conventional treatment combined with hyperbaric oxygen therapy).The clinical efficacy of the two groups after 30 days of treatment were compared.The prognosis of children with limb paralysis in the observation group after 30 days of hyperbaric oxygen treatment was compared with that of the control group at the same time point.Results The total effective rate of the treatment group(85.4%)was significantly higher than that of the control group(71.9%)(χ^(2)=7.114,P<0.05).The signs and symptoms of fever,convulsion,coma,delirium,cranial nerve involvement,and meningeal irritation of the treatment group recovered earlier than those of the control group(P<0.05).After treatment,the limb function scores of children with limb paralysis in the treatment group were significantly higher than those in the control group(P<0.05).The improvement rate of brain lesions on MRI in the treatment group(86.5%)was significantly higher than that in the control group(71.9%)(χ^(2)=6.138,P<0.05).Conclusion The treatment combined with hyperbaric oxygen can shorten the duration of clinical symptoms and signs of children with severe VE,significantly improve the brain lesions on MRI,accelerate the recovery of limb dyskinesia,and shorten the length of hospital stay.

关 键 词：高压氧 小儿 病毒性脑炎 

分 类 号：R742.9[医药卫生—神经病学与精神病学]