散发性脑炎204例临床分析

Clinical Analysis of 204 Patients with Sporadic Encephalitis

目的:探讨散发性脑炎患者的临床特点、早期诊断以及疾病的转归。方法:回顾性分析我科1996年至2006年住院收治的204例符合"散发性脑炎"临床诊断标准患者的临床资料。结果:204例患者中以头痛、恶心、呕吐起病的106例(51.96%),首发症状为癫55例(26.96%),首发为精神症状27例(13.24%),表现为昏迷9例(4.41%),偏瘫7例(3.43%);EEG检查异常134例(76.57%);脑CT检查异常4例(12.12%),脑MRI检查异常24例(37.5%);脑脊液细胞数、糖和氯化物均在正常范围的分别为68.63%、77.45%和51.47%;蛋白正常的为52.45%;外周血白细胞升高的为33.17%,以中性粒细胞升高为主,淋巴细胞升高只占11.39%。随访:204例患者中,治愈率64.22%,好转率29.41%,病死率0.98%,失随访率5.39%。结论:散发性脑炎表现多样,其诊断应以临床症状及相关检查综合分析,而不能靠一种症状来确诊。散发性脑炎患者一般预后良好。

Aim. To investigate the clinical characteristic, the early clinical diagnosis and prognosis of sporadic encephalitis patients. Mothods. To retrospectively analyze 204 cases in 1996-2006 years which coincide with the clinical diagnosis criteria of sporadic encephalitis. Results： Headache, nausea and vomiting （51.96%）, epileptic（26.96%）, altered mental status（1 3.24%）,coma（4.41%）, hemiplegia（3.43%）were the major clinical findings in 204 cases. About 76.57% patients were abnormal in EEG examination, and this is higher rate than others examinations. 37.5% patients were abnormal in cerebral MRI. But the data of the cerebral CT showed that only the 12.12% patients was abnormal. These clinical data showed that the curative patient was 64.22%, the improved was 29.41% and the death was 0.98%. Conclusion： The sporadic encephalitis appearance is multiplicity, to diagnose the disease needs aggregatirely analyze the clinical symptom and comprehensive check. The prognosis of sporadic encephalitis patients may be well in general.