發(fā)布時(shí)間：2018-02-28 07:52

  本文關(guān)鍵詞： 病毒性腦炎 癲癇 兒童 危險(xiǎn)因素 預(yù)后　出處：《四川大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年02期 　論文類型：期刊論文

【摘要】：目的探討兒童病毒性腦炎急性期臨床病理特征對(duì)繼發(fā)癲癇的發(fā)生、控制情況和預(yù)后的影響。方法納入2010年1月至2014年1月我院收治的病毒性腦炎患兒,回顧性分析其繼發(fā)性癲癇控制情況,運(yùn)用格拉斯哥預(yù)后量表評(píng)價(jià)患兒預(yù)后,對(duì)急性期臨床病理特征(包括臨床表現(xiàn)、病毒學(xué)、腦電監(jiān)測(cè)、影像學(xué)等)資料進(jìn)行統(tǒng)計(jì)分析,采用多因素logistic回歸分析病毒性腦炎繼發(fā)癲癇、癲癇控制差及預(yù)后不良的危險(xiǎn)因素。結(jié)果(1)共納入506例病毒性腦炎患兒,經(jīng)1.5年以上隨訪,繼發(fā)癲癇58例(11.46%)。(2)Logistic回歸分析示急性期反復(fù)抽搐發(fā)作(標(biāo)準(zhǔn)偏回歸系數(shù)=3.602)、腦電監(jiān)測(cè)到臨床發(fā)作(標(biāo)準(zhǔn)偏回歸系數(shù)=3.061)、癲癇持續(xù)狀態(tài)(標(biāo)準(zhǔn)偏回歸系數(shù)=2.711)、精神行為性格改變(標(biāo)準(zhǔn)偏回歸系數(shù)=1.850)為病毒性腦炎患兒繼發(fā)癲癇的危險(xiǎn)因素。(3)繼發(fā)性癲癇患兒中40例控制好(74.07%),其中37例(92.5%)使用≤2種抗癲癇藥物;logistic回歸分析未提示病毒性腦炎繼發(fā)癲癇患兒癲癇控制差的危險(xiǎn)因素。(4)格拉斯哥預(yù)后量表評(píng)分示24例預(yù)后不良(41.38%),主要表現(xiàn)為智力運(yùn)動(dòng)落后(20例,83.33%)。單因素分析提示急性期癲癇持續(xù)狀態(tài)在繼發(fā)性癲癇患兒不同預(yù)后組間存在差異(P0.05),logistic回歸分析未提示病毒性腦炎繼發(fā)癲癇患兒預(yù)后不良的危險(xiǎn)因素。結(jié)論急性期精神行為性格改變、多次抽搐發(fā)作、癲癇持續(xù)狀態(tài)、腦電監(jiān)測(cè)到臨床發(fā)作是兒童病毒性腦炎繼發(fā)性癲癇的危險(xiǎn)因素,但急性期的臨床病理特征與病毒性腦炎繼發(fā)癲癇臨床控制差和臨床預(yù)后不良無(wú)關(guān)。
[Abstract]:Objective to investigate the effect of clinical and pathological features of viral encephalitis on the occurrence, control and prognosis of secondary epilepsy in children with viral encephalitis. Methods from January 2010 to January 2014, children with viral encephalitis were treated in our hospital. The control of secondary epilepsy was analyzed retrospectively, the prognosis of children was evaluated by Glasgow prognosis scale, and the clinical and pathological features (including clinical manifestations, virology, EEG monitoring, imaging, etc.) were statistically analyzed. Multivariate logistic regression analysis was used to analyze the risk factors of epilepsy secondary to viral encephalitis, poor control of epilepsy and poor prognosis. Results: a total of 506 children with viral encephalitis were followed up for more than 1.5 years. Logistic regression analysis of 58 cases of secondary epilepsy showed recurrent seizures in acute phase (standard partial regression coefficient 3.602), EEG monitoring of clinical seizures (standard partial regression coefficient 3.061), epileptic status (standard partial regression coefficient 2.711, mental behavior personality change). The risk factor of secondary epilepsy in children with viral encephalitis was 1.850 (standard partial regression coefficient: 1.850). In 40 children with secondary epilepsy, 74.07G was well controlled, and 37 patients were treated with 92.5g). Logistic regression analysis with 鈮，

本文編號(hào)：1546421