儿童部分脱髓鞘病病因及诊治(附16例临床分析)

Detection of the Cause,Diagnosis and Treatment about Some of Encephalomyelopathy in Children (Attached Clinical Analysis of 16 Cases)

目的：分析部分小儿髓鞘破坏型脱髓鞘病的病因及主要临床特征，探讨诊治措施。方法：对７例视神经脊髓炎、６例急性播散性脑脊髓炎、３例多发性硬化病例进行分析。结果：１６例中５例病前３周内具病毒感染史，７例病前３周内具疫苗接种史。经诊治痊愈８例，好转５例，复发１例，未愈２例。结论：该类脱髓鞘病多以病毒感染或疫苗接种为诱因，机体的异常免疫反应在本病的发生、发展过程中起重要作用。临床特征为病灶多发、分布紊乱、大小不一。颅脑ＣＴ及ＭＲＩ、脑脊液、血清免疫学等检查有助确诊。治疗应以合理应用糖皮质激素为主。

Objective:The cause and clinical features with some of demyelinizing encephalomyelopathy in children were analyzed to study the diagnosis and treatment methods.Method:Sixteen patients were analyzed,including 7 cases with devic disease,6 cases with acute dissemmated encephalomyelitis,3 cases with multiple selerosis.Result:Of 16 cases,5 patients suffered from virual infection and 7 patients vaccinated prior to three weeks.Through treatment 8 patients were cured,5 patients got better,2 patients irrecovered,1 patient relapsed.Conclusion:The abnormal immune response related to virual infection or vaccination,which has played an important role in the occurence and development of this disease.The clinical features are that the foci are multiple, different in size and distribution.The diagnosis depends on these features,craniocerebral CT and MRI, cerebrospinal fluid examination,seroimmunologic test.The treatment with this disease is reasonable application of glucocorticoid.