摘要
目的 探讨儿童重症单纯疱疹病毒性脑炎 (HSE)的临床特点和诊治。方法 回顾性分析 2 1例重症单纯疱疹病毒性脑炎患儿的临床表现、特异性检验、辅助检查和治疗方法。结果 本组 2 1例重症单纯疱疹病毒性脑炎患儿 ,发热 2 1例 ,抽搐 2 1例 ,昏迷 19例 ,烦燥 2例 ,面神经受累 2例 ,展神经受累 1例 ,继发癫痫 7例。MRI或CT检查 19例 ,14例异常 ,EEG检查 18例 ,异常 17例 ,BAEP检查 13例 ,8例异常。应用酶链免疫吸附试验测定血清HSV Ⅰ型IgM阳性 2 1例。抗病毒 (首选无环鸟苷 ,辅以干扰素、丙种球蛋白 )、静脉用地塞米松、脱水、抗癫痫、营养神经等治疗 ,治愈 12例 ,好转 7例 ,2例自动出院。结论 儿童重症单纯疱疹病毒性脑炎病情重 ,预后差。在头颅CT未出现异常之前 ,EEG和BAEP可辅助了解脑部病变情况。无环鸟苷治疗有效。
Objective To study the clinic characteristic and treatment of children with severe herpes simplex encephalitis(HSE). Methods Retrospective analysis of the clinic characteristic, specific test, accessory examination and treatment in 21 children with severe type of HSE. Results Among all the cases, 21 patients had fever, 21 had tic, 19 had coma. secondary epilepsy in 7. CT and/or MRI of the brain revealed abnomalities 14 of 19 patients, BAEP in 8 of 13 and EEG in 17 of 18. The positive HSV-Ⅰ IgM was detected by enzyme-linked immunosorbent assay (ELISA). The first choice of anti-virus was acyclovir, accessory treatment included intravenous dexamethasone, dehydrant, etc. Twelve patients cured completely, seven had significant improvement, and two was discharge from the hospital. Conclusion HSE were severe, prognosis of which was unfavourable. EEG and BAEP would be helped to determinant the lesion of the brain before CT didn't reveal abnormal. Acyclovir had an effect on the treatment of HSE.
出处
《广州医药》
2004年第4期39-40,共2页
Guangzhou Medical Journal
