迁延难愈性病毒性脑炎的治疗(附10例报告)

The Therapy Strategy of Protracted Viral Encephalitis(10 Cases Report)

目的 探讨迁延难愈性病毒性脑炎的治疗策略及预后评价。方法对10例迁延难愈性病毒性脑炎患者进行回顾性分析，其中男1例、女9例，年龄15～38岁，平均24岁。10例患者均曾接受1个月以上的常规抗病毒药物（更昔洛韦或阿昔洛韦）及糖皮质激素治疗（甲泼尼松龙或地塞米松）。入组时中枢神经系统感染严重程度评分（CSSCNS）平均11．7分。患者住院治疗43～270d。结果患者全部好转，无一例死亡。出院时2例伴智能障碍，1例伴肢体抽搐发作，CSSCNS平均4．4分。结论 延长抗病毒治疗时间并联用激素治疗有助于改善迁延难愈性病毒性脑炎的预后。

Objective To analyze the therapy strategy and prognosis of protracted viral encephalitis, Methods Ten cases with protracted viral encephalitis were included. One case was male, others were female with the average age of 24 years （15 to 38）. All cases were given antiviral drug （ganciclovir or acyclovir） and steroid （methylprednisolone or dexamethansone） for more than 1 month. When admitted, they were scored by Clinical Severity Scale for Central Nervous System Infection （CSSCNS） and the average score was 11.7. Results All cases were improved when they discharged. Their average CSSCNS was 4.4. Only two cases had the slight disturbance of intelligence, One case had seizure attacks. Conclusions Prolonging the course of antiviral and steroid therapy can be helpful to improve the prognosis of protracted viral encephalitis.