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【目的】探讨儿童患者超剂量应用抗生素致抗生素脑病的临床特点及病毒性脑炎临床鉴别。【方法】用HIS系统检索和查阅病历资料,回顾2009年1月20日-2011年6月20日某医院临床诊断为病毒性脑炎患儿504例,记录患儿临床用药史,疾病发生与演变过程,临床治疗与检查结果,分析儿童抗生素脑病临床特点及儿童病毒性脑炎的鉴别。【结果】儿童抗生素脑病与超剂量应用抗生素直接相关,临床表现为呕吐、意识障碍、抽搐、腹泻、脑膜刺激征,实验室检查、病原学检查和脑影像学检查阴性,脑脊液压力、白细胞数(>200)、降钙素原(procalcitonin,PCT)较病毒性脑炎低,两组患儿统计数据差异有统计学意义(P<0.05)。【结论】儿童超剂量应用抗生素是抗生素脑病的直接因素,严格掌握抗生素的使用指征、种类、用法用量是预防的关键;充分了解患儿抗生素应用情况结合实验室检查、病原学检查和脑组织影像学检查是鉴别病毒性脑炎的可靠依据。
【Objective】 To investigate the clinical features of antibiotic-induced antibiotic encephalopathy in children and the clinical identification of viral encephalitis. 【Methods】 The HIS system was used to search and review the medical records. The clinical records of 504 children with viral encephalitis in a hospital from January 20, 2009 to June 20, 2011 were retrospectively reviewed. The clinical history, Evolution, clinical treatment and test results, analysis of clinical features of children with antibiotic encephalopathy and identification of viral encephalitis in children. 【Results】 The results showed that children’s antibiotic encephalopathy was directly related to overdosing antibiotics. The clinical manifestations were vomiting, disturbance of consciousness, convulsions, diarrhea, meningeal irritation, laboratory tests, etiological examination and negative brain imaging examinations, cerebrospinal fluid pressure, leukocyte count > 200). Procalcitonin (PCT) was lower than that of viral encephalitis. There was significant difference between the two groups (P <0.05). 【Conclusion】 The application of antibiotics in children overdoses is the direct factor of antibiotic encephalopathy. Strictly grasping the indications, types and dosage of antibiotics is the key point of prevention; fully understanding the application of antibiotics in children combined with laboratory tests, etiological examination and brain tissue Imaging examination is to identify a reliable basis for viral encephalitis.