摘要
目的探讨肠道病毒71型(EV71)脑干脑炎患儿的临床特征及治疗措施。方法选择菏泽市中医院2009年3-4月收治的EV71型感染手足口病(HFMD)并脑干脑炎病例(脑干脑炎组)及EV71型感染HFMD未并神经系统损伤病例(对照组),每组各20例。对二组患儿的临床资料(皮疹情况、神经系统受累症状和体征、辅助检查、治疗及转归等)进行回顾性分析。结果脑干脑炎组患儿年龄多在24个月以下,病情进展迅速。二组患儿均有皮疹和发热,不同部位皮疹量比较差异均无统计学意义(Pa>0.05)。脑干脑炎组最常见的临床表现为精神差、肌阵挛、抽动、易惊或烦躁、呕吐、震颤等。与对照组比较,脑干脑炎组患儿的发热热峰[(38.83±0.33)℃vs(38.43±0.55)℃]、心率[(154.25±25.81)次.m in-1vs(119.65±10.97)次.m in-1)]、收缩压[(15.56±1.89)kPavs(12.88±1.16)kPa]、舒张压[(10.14±1.53)kPavs(9.02±0.89)kPa]、血WBC计数[(9.10±3.49)×109L-1vs(7.24±1.42)×109L-1]、血糖[(7.23±3.92)mmol.L-1vs(4.90±1.82)mmol.L-1]均明显升高,其差异均有统计学意义(Pa<0.05)。所有患儿均按照分期治疗原则进行治疗,疗效较好。结论 EV71型脑干脑炎起病凶险,充分了解该病特点,早期识别出重症病例,并按照分期治疗原则进行治疗,对降低病死率有重要意义。
Objective To explore the clinical features and management experience of enterovirus 71（EV71） related brain stem ence-phalitis.Methods The cases of EV71 related hand-foot-mouth disease（HFMD） who were admitted into Heze Traditional Chinese Medical Hospital from Mar.to Apr.2009 were collected.The patients were divided into 2 groups according to whether combing with brain stem ence-phalitis [brain stem encephalitis group（n=20） and control group（n=20）].The clinical data,including rash,neurologic complications,examination,therapy and prognosis etc.of these children were analyzed retrospectively.Results In brain stem encephalitis group,children were majority under the age of 24 months,clinical progress developed rapidly.All the cases of the 2 groups had skin rash and fever.There were no significant differences between the 2 groups in rash distribution（Pa0.05）.The most common clinical manifestations of brain stem encephalitis children included fatigue,myoclonic jerks,irritation,vomiting,tremor,etc.Compared with control group,eaking febrile[（38.83±0.33）℃ vs（38.43±0.55）℃],heart rate[（154.25±25.81）beats·min-1 vs（119.65±10.97）beats·min-1],systolic blood pressure[（15.56±1.89） kPa vs（12.88±1.16） kPa],diastolic blood pressure[（10.14±1.53） kPa vs（9.02±0.89） kPa],white blood cell count[（9.10±3.49）×109L-1 vs（7.24±1.42）×109L-1],glucose[（7.23±3.92） mmol·L-1 vs（4.90±1.82） mmol·L-1]in brain stem encephalitis group significantly increased,the differences were significant（Pa0.05）.The treatment according to disease phase was effective.Conclusions EV71 related brain stem encephalitis are in relatively serious condition,comprehension the diseases,early recognition of severe cases and according to phase-specified treatment are very important to reduce fatality rate.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2010年第22期1741-1743,共3页
Journal of Applied Clinical Pediatrics
基金
山东省科技攻关计划项目(2009GG10002048)
关键词
肠道病毒71型
脑炎
临床研究
enterovirus 71
encephalitis
clinical research
