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目的 回顾性分析小儿病毒性脑炎的临床资料 ,探讨影响近期预后的预警因素。方法 对 1997～ 2 0 0 3年上海第二医科大学附属新华医院收治的 10 1例病毒性脑炎患儿的临床表现及实验室检查进行回顾性分析 ,对近期预后进行评估 ,采用SPSS 10 0统计软件分析 ,寻找可能的预警因素。结果 近期预后差的患儿意识障碍持续时间、发热时间、惊厥发作时间均明显长于预后好的患儿 ( P <0 0 1)。预后差的患儿入院时多伴有惊厥 ( P <0 0 1) ,肢体运动障碍 (P <0 0 1) ,颅神经麻痹 (P <0 0 1)及其他脏器功能损害 (P <0 0 1)。其中 ,间歇性惊厥发作时间 (OR值 9 35 7,P =0 0 0 2 )是影响近期预后的重要临床预警因素。近期预后差的患儿脑脊液白细胞数低于预后好的 (P <0 0 1) ,脑电图高度异常的比例高 (P <0 0 1) ,脑电图恢复正常较慢 (P <0 0 1) ,多伴有影像学异常 (P <0 0 1)及低钠血症 (P <0 0 1)。其中 ,脑电图恢复慢是近期预后差的实验室预警因素。结论 小儿病毒性脑炎近期预后差的预警因素是惊厥发作时间长、脑电图恢复慢
Objective To retrospectively analyze the clinical data of pediatric viral encephalitis and explore the early warning factors that affect the prognosis in the near future. Methods The clinical manifestations and laboratory tests of 101 children with viral encephalitis admitted to Xinhua Hospital Affiliated to Shanghai Second Medical University from 1997 to 2003 were retrospectively analyzed. The prognosis was evaluated by SPSS 100 Statistical software analysis, looking for possible early warning factors. Results The children with poor prognosis recently had longer duration of ADHD, fever and convulsions than those with good prognosis (P <0.01). Children with poor prognosis were more likely to have convulsions (P <0.01), limb dyskinesia (P <0.01), cranial nerve palsy (P <0.01), and other organ dysfunction (P <0 0 1). Among them, the time of intermittent seizure (OR = 9357, P = 0.00002) is an important clinical prognostic factor of early warning. The recent poor prognosis of children with cerebrospinal fluid leukocyte count was lower than the good prognosis (P <0.01), a high proportion of abnormal EEG (P <0.01), EEG recovery was normal (P <0 0 1), accompanied by multiple imaging abnormalities (P <0.01) and hyponatremia (P <0.01). Among them, the slow recovery of EEG is the laboratory prognostic factors of poor prognosis. Conclusion Early prognosis of viral encephalitis in children is an early warning factor is longer episodes of seizures, EEG recovery slow