儿童病毒性脑炎112例的临床分析

Clinical analysis of 112 cases of children with viral encephalitis

目的回顾性分析阿糖腺苷在病毒性脑炎儿童治疗中的疗效。方法选择从2013年3月至2015年3月来陕西省子长县人民医院就诊的病毒性脑炎儿童共112例,采用随机数字表法分组分为对照组和治疗组,每组56例。对照组患儿进行常规对症支持治疗,治疗组患儿在常规治疗的基础上加用阿糖腺苷治疗1周,观察两组患儿相关指标变化及临床症状消退时间,并进行对比分析。结果通过治疗后,两组患儿CD3+(t值分别为2.153和3.623,均P<0.05)、CD4+(t值分别为3.284和4.723,均P<0.05)、CD8+(t值分别为3.532和4.734,均P<0.05)的数量均明显增加,与治疗前相比具有显著性差异(均P<0.05);临床症状方面,治疗组患儿发热消退时间(t=3.256,P<0.05)、呕吐、头疼的消失时间(t=3.627,P<0.05)明显短于对照组,且住院时间也短于对照组(t=5.934,P<0.05),结果有统计学意义(P<0.05);在治疗组中,患儿的总治愈率为94.6%,明显高于对照组的62.5%,结果有统计学意义(χ2=12.823,P<0.05);患儿并发症的发病率治疗组为7.1%,对照组为8.9%,无统计学意义(χ2=0.121,P>0.05)。结论使用阿糖腺苷治疗儿童病毒性脑炎具有较好疗效,能够明显提高患儿T细胞水平,改善其临床症状,且并发症较低,有较好的安全性,值得在临床上推广使用。

Objective To retrospectively analyze the therapeutic effect of adenosine in the treatment of children with viral encephalitis.Methods A total of 112 children with viral encephalitis visiting People＇s Hospital of Zichang County in Shaanxi Province from March 2013 to March 2015 were divided into control group and treatment group with 56 cases in each group. Patients in the control group were treated with routine supportive therapy,while patients in the treatment group were treated with routine supportive therapy and adenosine for 1week. Then the changes of related indexes and the subsidizing time of clinical symptoms of two groups were observed and analyzed. Results After the treatment,there was an obvious increase in CD3＋（ t value was 2. 153 and 3. 623,respectively,both P〈0. 05）,CD4＋（ t value was 3. 284 and 4. 723,respectively,both P〈0. 05）,and CD8＋（ t value was 3. 532 and 4. 734,respectively,both P〈0. 05） of two groups of children with significant difference from the pre-treatment situation（ P〈0. 05）. On clinical symptoms,the subsidizing time of fever（ t = 3. 256,P〈0. 05）,vomiting and headache（ t = 3. 627,P〈0. 05） of treatment group was significantly shorter than that of the control group,and the length of hospital stay of the former was also shorter than the latter（ t = 5. 934,P〈0. 05）. As a result,there was statistical significance（ P〈0. 05）. In the treatment group,the total cure rate was 94. 6%,which was significantly higher than that of the control group（ 62. 5%） with statistical significance（ χ2= 12. 823,P〈0. 05）. The incidence of complications in the treatment group was7. 1% while that in the control group was 8. 9%. The result was not statistically significant（ χ2= 0. 121,P〉0. 05）. Conclusion Using adenosine in the treatment of children with viral encephalitis has better curative effect,which can significantly improve T-cell levels of children and improve the clinical symptoms with lower incidence of complications and better security. Thus it is worth promotion and application clinically.