儿童肠道病毒相关性脑炎37例临床特点分析

Clinical characteristics of 37 cases of enterovirus associated encephalitis in children

目的探讨肠道病毒相关性脑炎患儿的临床特点;以期能为临床医师对该病的认识提供一定的帮助。方法回顾性分析2018年1月—2019年12月广州市妇女儿童医疗中心感染科收治的37例肠道病毒相关性脑炎患儿的临床相关资料。结果37例患儿男28例,女9例,男女比例3.11:1。主要临床症状体征发热(97.30%)、口腔疱疹和(或)皮疹(54.05%);常见神经系统症状呕吐(56.76%)、头痛(56.76%)、惊厥(29.72%),其中惊厥及呕吐头痛症状≤1岁组与其他年龄组差异有统计学意义;脑脊液检查白细胞升高为主;所有患儿均康复出院且无神经系统后遗症。结论儿童肠道病毒相关性脑炎近一半患儿临床无咽部疱疹或皮疹表现,1岁以内患儿主要以发热及惊厥为主要表现,大于1岁尤其学龄前期及学龄期患者以发热呕吐伴头疼为主要表现;早期诊治预后良好。

Objective To explore the clinical characteristics of children with enterovirus associated encephalitis,in order to provide some help for clinicians to understand the disease.Methods The clinical data of 37 children with enterovirus related encephalitis treated in the infection department of Guangzhou Women and Children's Medical Center from January 2018 to December 2019 were analyzed retrospectively.Results There were 28 males and 9 females,with a male to female ratio of 3.11:1.The main clinical symptoms and signs were fever(97.30%),oral herpes and/or rash(54.05%);the common nervous system symptoms were vomiting(56.76%),headache(56.76%)and convulsion(29.72%).There were significant differences in convulsion,vomiting and headache symptoms between≤1 year old group and other age groups.The leukocytes level in cerebrospinal fluid was elevated.All children recovered and discharged without neurological sequelae.Conclusions Nearly half of children with enterovirus associated encephalitis had no clinical manifestations of pharyngeal herpes or rash.The main manifestations of children under 1 year old were fever and convulsion.The main manifestations of children over 1 year old,especially preschool and school-age patients,were fever and vomiting with headache.Early diagnosis and treatment had good prognosis.