小儿急性脊髓炎31例临床特征及早期激素治疗效果观察

Clinical characteristics and steroids therapeutic efficacy in earlier period in children′s acute myelitis

目的 探讨儿童急性脊髓炎临床特点 ,激素治疗效果及预后。方法 回顾性分析了 31例儿童急性脊髓炎的临床表现 ,实验室检查结果和对激素治疗的反应 ,并对其中 2 0例患者进行了 6～ 5 8个月随访。结果 运动及植物神经功能障碍 31例 ,感觉障碍 2 0例 ,脑脊液异常 9例 ,神经电生理异常 1 7例 ,神经影像学检查异常 1 6例 ,甲强组和地米组治疗近期有效率为 5 8 5 %、35 7% ,总有效率为 82 4 %、6 4 3% ,两者相比差异显著 (χ2 =4 92 8～ 8 6 72 ,P <0 0 5～ 0 0 1 )。随访 2 0例患者痊愈 1 7例 ,好转 3例。结论 儿童急性脊髓炎早期激素治疗效果好 。

Objective To explore clinical characteristics,steroids therapeutic efficacy and prognoses with children′s acute myelitis.Methods The clinical situation,laboratory examination and steroids therapeutic efficacy of 31 cases suffering from acute myelitis were retrospectively analyzed,and 20 patients of 31 were follow up between 6 to 58 months.Results Clinical feature included motor and vegetative nerve functional disturbance 31 patients and sensory disturbance 20 cases.Laboratory examination included cerebrospinal fluid abnormal 9 cases,electrophysiologic study abnormal 17 and screenage examination abnormal 16.The rates of recover from the illness in short term and general efficiency in methylprednisolone groups and dexasone groups were 58.5%,35.7% and 82.4%,64.3%,respectively.And significantly difference can be found between of them(χ 2=4 928～8.672, P <0 05).Follow up after the disease to 20 patients found that 17 cases were fully recovered and the others were partly improved.Conclusion The therapeutic efficacy to steroid is better in children with acute myelitis,and the sequela is less.