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目的通过对43例儿童脑脓肿病例的分析,进一步认识该病的临床特点。方法回顾上海第二医科大学附属新华医院小儿神经内科1994—2006年就诊的43例儿童脑脓肿的临床表现、致病因素、实验室检查、影像学表现和治疗结果,进行分析。结果临床表现:发热26例(60.5%)、抽搐22例(51.2%)、头痛18例(41.9%)、呕吐15例(34.9%)。先天性心脏病是儿童脑脓肿最常见的致病因素(22例,51.2%),其次为原因不明(12例,27.9%)。有影像资料的共40例,其中合并有先天性心脏病的20例。儿童脑脓肿发生部位以额叶、顶叶较为多见,额叶为20例(50%)、顶叶为15例(37.5%);在非先天性心脏病的脑脓肿患儿以单个脓肿多见为15例(75.0%),而先天性心脏病的脑脓肿患儿中则以多发性脓肿多见为12例(60.0%)。结论儿童脑脓肿的临床表现具有多样性,影像学检查对于脑脓肿的诊断有重要意义。
Objective To further understand the clinical features of 43 cases of children with brain abscess. Methods The clinical manifestations, pathogenic factors, laboratory tests, imaging findings and treatment results of 43 children with brain abscess admitted to the Department of Pediatric Neurology, Xinhua Hospital, Shanghai Second Medical University from 1994 to 2006 were reviewed. Results Clinical manifestations: fever in 26 cases (60.5%), convulsions in 22 cases (51.2%), headache in 18 cases (41.9%) and vomiting in 15 cases (34.9%). Congenital heart disease is the most common cause of brain abscess in children (22 patients, 51.2%), followed by unexplained (12 patients, 27.9%). A total of 40 cases of imaging data, including 20 cases of congenital heart disease. In children with brain abscess, the frontal lobe and parietal lobe were more common. The frontal lobe was 20 (50%) and the parietal lobe was 15 (37.5%). In children with non-congenital heart disease, multiple abscesses See 15 cases (75.0%), while the children with congenital heart disease in children with multiple abscess more common in 12 cases (60.0%). Conclusion The clinical manifestations of brain abscess in children are diverse. The imaging examination is of great significance for the diagnosis of brain abscess.