摘要
目的评估重症病毒性脑炎(SVE)患儿的预后,探讨影响其预后的因素。方法回顾性分析2009年1月-2010年8月中国医科大学附属盛京医院儿科收治的56例SVE患儿的临床资料,并在患儿出院4个月后采用Liverpool预后评分量表评估其预后。根据预后将患儿分为治愈组和未愈组,采用SPSS 13.0软件进行数据处理,采用t检验和Binary Logistic回归检验分析2组临床资料与预后的相关性。结果 35%(19/54例)的SVE患儿死亡或留有严重神经系统后遗症,其中住院期间死亡7例(13%),随访中死亡3例(6%),留有严重后遗症9例(17%)、中度后遗症7例(13%)、轻微后遗症5例(9%)。导致SVE患儿预后不良的有统计学意义的因素有脑电图中度异常、惊厥持续状态、发热病程长、头颅MRI累及病灶超过2处或累及幕下及合并应激性高血糖(Pa<0.05),而脑脊液白细胞数、脑脊液蛋白量、偏瘫、意识障碍、合并多脏器损伤、低钾血症、低钠血症与SVE预后不良无关。结论 SVE严重威胁儿童的生存质量。伴有惊厥持续状态、应激性高血糖、发热时间长、脑电图中度异常及累及病灶超过2处或累及幕下等是影响儿童SVE预后的危险因素。
Objective To evaluate the prognosis of severe viral encephalitis（SVE）in children,and to investigate the related prognostic factors for SVE. Methods A retrospective analysis was conducted on 56 SVE inpatient clinical data from pediatric wards of China Medical University Affiliated Shengjing Hospital,covering from Jan.2009 to Aug.2010.These children were divided into 2 groups（incurable group and curable group） and followed up at least 4 months after discharging from the hospital.Their prognosis was valued with the Liverpool Outcome Score.The data were processed by SPSS 13.0 saftware,t test and Binary Logistic regression were used to analyze the correlation between clinical data and the prognosis in the 2 groups. Results Thirty-five percent（19/54 cases） of children with SVE died or had severe neurological sequelae,of which 7 cases（13%） died during hospitalization,3 cases（6%） died during follow-up,9 cases（17%） had severe sequelae,7 cases（13%） had mild sequelae and 5 cases（9%） had minor sequelae.The statistically significant factors for SVE children with poor prognosis were moderately abnormal electroencephalogram,convulsive status,long-time fever,stress hyperglycemia,and head MRI lesions involving more than two or lesions involving the infratentorial（Pa〈0.05）,while cerebrospinal fluid white blood cell count,cerebrospinal fluid protein,paralysis,unconsciousness,multiple organ injury,hypokalemia,hyponatremia had nothing to do with poor prognosis in children with SVE. Conclusions The SVE is a serious threaten to quality of children′s life.Some of the symptoms are associated with convulsive status,stress hyperglycemia,long-time fever,moderately abnormal electroencephalogram and head MRI lesions involving more than two or lesions involving the infratentorial may be risk factors for SVE affecting the prognosis of children.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2011年第23期1817-1820,共4页
Journal of Applied Clinical Pediatrics
