小儿病毒性脑炎近期预后的相关危险因素调查分析

Correlated risk factors of recent prognosis of children viral encephalitis

目的:探讨病毒性脑炎患儿近期预后的临床特点及其相关危险因素,为改善预后提供依据。方法:对165例病毒性脑炎患儿进行6个月的随访,依据GOS评分分为预后不良组(47例)和预后良好组(165例);分析预后不良发生率,采用单因素和多因素法筛选影响预后不良的相关危险因素。结果:病毒性脑炎患儿6个月的近期预后不良发生率为28. 5%(47/165);多因素分析显示,影响病毒性脑炎患儿近期预后不良的危险因素包括发热至治疗时间(OR=1. 716)、重症病毒性脑炎(OR=5. 114)、病灶多发(OR=2. 959)、CT或MRI检查异常(OR=3. 539)、肺部感染(OR=2. 385)等。结论:病毒性脑炎患儿,尤其是重症患儿,病情进展较为迅速,近期预后效果较差;应针对这些危险因素,早检查、早诊断、早治疗病毒性脑炎,从而改善其预后。

Objective To explore the clinical characteristics and correlated risk factors of recent prognosis of children viral encephalitis,to provide basis for improving its prognosis. Methods A hundred and sixty-five cases of children viral encephalitis received 6 months of follow-up,and these children patients were assigned into poor prognosis group（47 cases） and good prognosis group（118 cases）. The rate of bad prognosis was analyzed,and the correlated risk factors were screened by single factors and multiple factors methods. Results The incidence rate of bad prognosis in 6 months was 28. 5%（47/165）. Multiple factors analysis result indicated that the risk factors of recent prognosis of children viral encephalitis included time from fever to treatment（OR = 1. 716）,severe viral encephalitis（OR = 5. 114）,multiple lesions（OR = 2. 959）,abnormality diagnosed by CT or MRI（OR = 3. 539） and pulmonary infection（OR = 2. 385）. Conclusions Children with viral encephalitis,especially severe patients,had quick disease progression and poor recent prognosis. It is necessary to carry out early examination,diagnosis and treatment aiming directly at these high risk factors to improve the prognosis.