儿童病毒性脑炎30例诊治分析

Diagnosis and Treatment of 30 Cases of Viral Encephalitis in Children

目的探讨儿童病毒性脑炎的临床诊断及疗效评价。方法回顾性分析30例临床确诊为病毒性脑炎患儿的临床症状、体征、脑脊液结果、脑电图与影像检查资料。结果 30例患者中有27例病前有其他部位的感染。症状以发热、呕吐及头痛为主,其他症状有抽搐16例,精神症状15例,合并脑膜刺激征和病理征3例,肌体轻瘫2例。脑脊液检查异常26例,脑电图异常25例,颅脑CT异常3例,MRI异常7例。采用止惊、退热、降低颅压、抗病毒等综合治疗,临床治愈20例,好转6例,转上级医院进一步治疗4例。结论儿童病毒性脑炎临床表现呈多样化,运用多种手段结合可获得早期诊断,进一步采取综合治疗可改善预后。

Objective To explore the clinical diagnosis and eficacy value of viral encephalitis in children.Methods The data of clinical symptoms,signs,the conventional and biochemical examination results cerebrospinal fluid,EEG and imaging in 30 cases with viral encephalitis were retrospectively analysed.Results In 30 cases there were 27 children with other parts of the disease before the infection disease.The clinical manifestations were all with fever,headache,vomiting;16 cases with twitching,15 cases with mental disorders,3 patients with merge meningeal stimulation and pathological levy,light body paralyzed in 2 cases,CSF abnormalities in 26 cases,eeg anomalies 25 patients,head CT abnormal in 3 patients and MRI 7.Using the jing,fever,reduces the cranial pressure,antiviral treatment,20 cases were clinically cured,6cases were clinically improved,and 4 cases turned to the superior hospital treatment.Conclusion The clinical manifestations of encephalitis in children were diversity.Using various means it could be obtained with early diagnosis and treatment were further improving the prognosis.