儿童感染新型冠状病毒后神经系统表现的特征  

Neurological manifestations of children infected with COVID-19

作　　者：王杰[1] 刘芳芳 马凯[1] 刘桂苓 刘勇[1] 金瑞锋 Wang Jie;Liu Fangfang;Ma Kai;Liu Guiling;Liu Yong;Jin Ruifeng(Department of Neurology,Children's Hospital Affiliated to Shandong University,Jinan 250022,China;Department of Ultrasound,Central Hospital Affiliated to Shandong First Medical University,Jinan 250013,China)

机构地区：[1]山东大学附属儿童医院神经内科,济南250022 [2]山东第一医科大学附属中心医院超声科,济南250013

出　　处：《国际医药卫生导报》2023年第16期2245-2250,共6页International Medicine and Health Guidance News

摘　　要：目的探讨儿童感染新型冠状病毒后神经系统表现的特征。方法回顾性总结、分析2022年12月1日至2023年1月31日在山东大学附属儿童医院神经内科和重症监护室住院治疗的109例具有神经系统症状的新型冠状病毒阳性患儿的临床资料,男58例,女51例,发病年龄为(55.5±43.9)个月。结果109例患儿中,有惊厥发作症状患儿85例(78.0%)[包括13例(11.9%)惊厥持续状态患儿],意识障碍患儿10例(9.2%),口角歪斜患儿3例(2.8%),走路不稳患儿4例(3.7%),语言障碍患儿4例(3.7%),肌肉疼痛3例(2.8%)。最终诊断为热性惊厥患儿36例(33.0%),脑炎患儿25例(22.9%),急性坏死性脑病12例(11.0%),急性坏死性脑病中包括放弃治疗患儿5例(4.6%),死亡患儿2例(1.8%),热性惊厥附加症患儿8例(7.3%),周围性面神经麻痹3例(2.8%)。结论新型冠状病毒奥密克戎毒株感染后儿童最常见的神经系统症状为惊厥发作,其次为意识障碍;最常见的神经系统疾病为热性惊厥、脑炎和急性坏死性脑病,其中急性坏死性脑病可导致患儿死亡。Objective To explore the neurological manifestations of children infected with COVID-19.Methods The clinical data of 109 children with COVID-19 infection and neurological symptoms who were treated at Department of Neurology and ICU of Children's Hospital Affiliated to Shandong University from December 1,2022 to January 31,2023 were retrospectively analyzed,including 58 boys and 51 girls.Their onset age was(55.5±43.9)months.Results Among the 109 children,85 children(78.0%)had convulsive seizures,including 13 cases(11.9%)of status epilepticus;10(9.2%)experienced consciousness disorders;3(2.8%)had deviation of mouth angles;4(3.7%)had walking lability;4(3.7%)had language disorders,3(2.8%)had muscle pain.Finally,36 cases(33.0%)were diagnosed as febrile seizures,25(22.9%)as encephalitis,12(11.0%)as acute necrotizing encephalopathy[including 5 ones(4.6%)who gave up the treatment and 2(1.8%)who died],8(7.3%)as febrile seizures plus,and 3(2.8%)as peripheral facial paralysis.Conclusions The most common neurological symptom in children infected with Omicron is convulsive seizures,followed by impaired consciousness.The most common neurological disorders are febrile seizures,encephalitis,and acute necrotizing encephalopathy;of which,acute necrotizing encephalopathy can lead to death in children.

关 键 词：新型冠状病毒 奥密克戎 儿童 发热性惊厥 急性坏死性脑病 

分 类 号：R725.1[医药卫生—儿科] R747.9[医药卫生—临床医学]