感染性脑炎及脑膜炎患儿视频脑电图的临床诊断分析

Clinical diagnosis of encephalitis and meningitis in children infection video EEG

目的分析并探讨视频脑电(VEGG)在感染性脑炎及脑膜炎患儿的临床应用价值,从而为临床诊治提供选择依据。方法选取2010年1月-2015年12月在医院接受诊治的170例感染性脑炎或脑膜炎患儿进行研究,患儿均采用视频脑电(VEGG)监护系统(Z2N-F-16W,上海诺诚)进行脑电监测,分析患儿脑电图异常特点,VEGG与CT检查对比及与临床分型和痊愈时间关系,数据采用SPSS 19.0统计软件进行处理。结果 170例患儿脑电异常者162例,异常率95.29%,其中轻度异常多表现为高幅θ波,θ波多有节律,偶伴少量δ波,中度异常多表现为高幅θ波活动,δ波逐渐频繁出现,重度异常多表现为弥漫性至中高幅度θ波,δ波呈短至中至长程出现;脑电图异常率为95.29%,明显高CT异常率61.18%,差异有统计学意义(P<0.05);感染性脑炎或脑膜炎患儿临床表型严重程度与脑电图异常程度呈正相关,差异有统计学意义(r=0.651,P<0.05);对患儿预后进行随访1年,162例脑电异常患儿痊愈153例,痊愈率94.44%;感染性脑炎或脑膜炎患儿痊愈时间与脑电图异常程度呈正相关,差异有统计学意义(r=0.423,P<0.05)。结论感染性脑炎或脑膜炎患儿视频脑电异常率高,且异常程度与表型和预后有相关性,可以为临床诊治提供重要参考。

OBJECTIVE To analyze and discuss video EEG（VEEG）clinical value in children infected with encephalitis and meningitis,so as to provides the basis for clinical diagnosis and treatment of choice.METHODS A total of170 cases of children with encephalitis or meningitis in our hospital from Jan.2010 to Dec.2015 were selected and monitored by computer through VEEG and monitoring system（Z2N-F-16 W,Shanghai Nuocheng）for the analysis of abnormal characters of encephlogram.The comparison between VEGG and CT,and the clinical categories,and the relation to recovery time were all under analysis.SPSS 19.0was used for data analysis.RESULTS From the170 patients,there were 162 cases with abnormal EEG,accounting for 95.29%.Among them,patients with mild abnormal EEG had more performance for the high amplitudeθwave,which had more than a rhythm,even with a small amount ofδwave.Moderately abnormal EEG had more performance for the high-amplitudeθwave activity,δwave gradually frequent.Severe abnormalities had more diffuse advice to wave amplitudeθ,andδwave had the trend of short to medium to long-range occurs.EEG abnormalities detection rate was 95.29%,and CT abnormality detection rate was 61.18%,so the EEG was significantly higher than CT detection rate（P〈0.05）.Infection encephalitis or meningitis in children with clinical phenotypes and severity was positively correlated with the degree of EEG abnormalities（r=0.651,P〈0.05）.Prognosis of patients were followed up for 1year.There were 153 cases of children recovered among the 162 cases with abnormal EEG,accounting for 94.44%.Encephalitis and meningitis in children infected recovery time was positively correlated with the degree of abnormal EEG（r=0.423,P〈0.05）.CONCLUSIONChildren with encephalitis or meningitis have high video EEG abnormality detection rate and the degree of abnormality positive related to phenotypes and prognosis,which can be used as an important reference for clinical diagnosis and treatment.