脑电图、脑脊液和头颅MRI在儿童病毒性脑炎早期阶段检测分析(1)

http://www.100md.com 2017年6月5日 《中国现代医生》 2017年第16期

     [摘要] 目的 调查脑电图(electroencephalogram，EEG)、脑脊液(cerebrospinal fluid，CSF)和头颅MRI在儿童型病毒性脑炎早期阶段的异常情况，为早期诊断提供参考。 方法 选择2014年1月～2016年12月在本地市、县两级医院住院的儿童病毒性脑炎170例，对入院后3 d内进行的EEG、CSF、头颅MRI检查结果进行统计分析。 结果 共168例开展EEG检查，异常率为83.93%(141/168)；共170例开展CSF检查，异常率为51.76%(88/170)；共168例开展头颅MRI检查，异常率为30.36%(51/168)，三个指标间差异有统计学意义(P<0.05)。共99例同时进行EEG、CSF检查，异常率分别为60.61%(60/85)、22.22%(22/99)；共85例同时进行EEG、头颅MRI检查，异常率分别为70.59%(60/85)、51.76%(44/85)；共88例同时进行CSF、头颅MRI检查，异常率分别为52.27%(46/88)、29.55%(26/88)；共83例同时开展了EEG、CSF、头颅MRI检查，异常率分别为81.93%(68/83)、66.27%(55/83)、48.19%(40/83)，不同组合的异常率差异有统计学意义(P<0.05)。 结论 EEG检查在病毒性脑炎的早期阶段敏感性更高。

    [关键词] 病毒性脑炎；脑电图；脑脊液；头颅MRI；诊断

    [中图分类号] R512.32； R445.2 [文献标识码] A [文章编号] 1673-9701(2017)16-0013-03

    [Abstract] Objective To investigate the abnormal situations of electroencephalogram(EEG)， cerebrospinal fluid(CSF) and head MRI in the early stage of children viral encephalitis， and to provide reference for early diagnosis. Methods A total of 170 cases of children viral encephalitis in the local city and county hospitals from January 2014 to December 2016 were collected. The results of EEG examination， CSF examination and head MRI examination performed within three days after admission were statistically analyzed. Results A total of 168 patients underwent EEG examination with an abnormal rate of 83.93%(141/168). A total of 170 patients underwent CSF examination with an abnormal rate of 51.76%(88/170). And 168 patients underwent brain MRI examination with an abnormal rate of 30.36%(51/168)， the difference between the three indicators was significant(P<0.05). A total of 99 cases took EEG and CSF simultaneously. The abnormal rate was 60.61%(60/99) and 22.22%(22/99) respectively. 85 patients underwent EEG and head MRI simultaneously. And the abnormal rate was 70.59%(60/85) and 51.76%(44/85)， respectively. 88 patients underwent CSF and head MRI simultaneously， and the abnormal rates were 52.27%(46/88) and 29.55%(26/88)， respectively. A total of 83 patients underwent EEG， CSF and MRI at the same time，with the abnormal rates of 81.93%(68/83)， 66.27%(55/83) and 48.19%(40/83) respectively. There were significant differences in the abnormal rates of different combinations(P<0.05). Conclusion EEG examination is more sensitive in the early stages of viral encephalitis.

    [Key words] Viral encephalitis； EEG； Cerebrospinal fluid； Head MRI； Diagnosis

    病毒性腦炎(viral encephalitis，VE)是由多种病毒引起的脑部炎症[1，2]，主要表现为大脑实质损害和颅内高压症状，临床症状包括高烧、头痛、对光敏感、颈和背部僵硬、呕吐，严重的情况下，癫痫发作、瘫痪和昏迷、死亡或留有严重的后遗症[3]。因此做到早期诊断、早期治疗对临床预后具有重要的意义。目前，脑电图(electroencephalogram，EEG)、脑脊液(cerebrospinal fluid，CSF)和头颅MRI等辅助检查在病毒性脑炎的诊断方面应用广泛[4-6]，为评价EEG、CSF和头颅MRI对儿童病毒性脑炎早期诊断的作用，对本地170例儿童病毒性脑炎数据进行分析，现报道如下。(许慧)

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