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目的:探讨散发性脑炎患者的临床特点、早期诊断以及疾病的转归。方法:回顾性分析我科1996年至2006年住院收治的204例符合“散发性脑炎”临床诊断标准患者的临床资料。结果:204例患者中以头痛、恶心、呕吐起病的106例(51.96%),首发症状为癫55例(26.96%),首发为精神症状27例(13.24%),表现为昏迷9例(4.41%),偏瘫7例(3.43%);EEG检查异常134例(76.57%);脑CT检查异常4例(12.12%),脑MRI检查异常24例(37.5%);脑脊液细胞数、糖和氯化物均在正常范围的分别为68.63%、77.45%和51.47%;蛋白正常的为52.45%;外周血白细胞升高的为33.17%,以中性粒细胞升高为主,淋巴细胞升高只占11.39%。随访:204例患者中,治愈率64.22%,好转率29.41%,病死率0.98%,失随访率5.39%。结论:散发性脑炎表现多样,其诊断应以临床症状及相关检查综合分析,而不能靠一种症状来确诊。散发性脑炎患者一般预后良好。
Objective: To investigate the clinical features of patients with sporadic encephalitis, early diagnosis and prognosis of the disease. Methods: A retrospective analysis of our department from 1996 to 2006 hospitalized 204 cases of patients with “sporadic encephalitis” clinical diagnostic criteria in patients with clinical data. Results: Among the 204 patients, there were 106 cases (51.96%) with headache, nausea and vomiting, the first symptom was epilepsy 55 cases (26.96%), the first symptom was 27 cases (13.24%) with coma, coma 9 cases 4.41%), hemiplegia in 7 cases (3.43%), abnormal EEG examination in 134 cases (76.57%), abnormal brain CT examination in 4 cases (12.12%) and brain MRI abnormality in 24 cases Chloride in the normal range of 68.63%, 77.45% and 51.47% respectively; normal protein was 52.45%; peripheral leukocytes increased to 33.17%, mainly to neutrophils, lymphocytes increased only Accounting for 11.39%. Follow-up: Among 204 patients, the cure rate was 64.22%, the improvement rate was 29.41%, the case fatality rate was 0.98% and the follow-up rate was 5.39%. Conclusions: The performance of sporadic encephalitis is diverse. The diagnosis should be based on clinical symptoms and related tests, but not by one symptom. Sporadic encephalitis patients generally have a good prognosis.