ABSTRACT
Objective To understand the clinical features and prognosis of children with severe viral encephalitis (SVE), evaluate the related factors affecting prognosis. Methods Clinical data of 102 children with SVE in pediatric neurological ward and pediatric intensive care unit in Hunan Children's Hospital between January 2014 and January 2016 were analyzed retrospectively. According to prognosis, children were divided into good prognosis group(n =24, children's Glasgow outcome scale[CGOS]: 4 — 5) and poor prognosis group(n = 78, CGOS: 1 - 3), clinical data of two groups of children were compared, risk factors affecting the prognosis of SVE children were analyzed. Results In good prognosis group, 15 cases were cured and 9 had mild sequelae; in poor prognosis group, 14 cases died, 25 had severe sequelae, and 39 had moderate sequelae. The duration of fever and length of hospital stay in good prognosis group were both shorter than poor prognosis group, difference was statistically significant (both P く0.05). Multivariate unconditioned logistic regression analysis showed that adverse factors for prognosis of SVE were as follows: convulsive status, respiratory failure, longer fever period(＞5 days), severely abnormal electroen-cephalogram(EEG), head magnetic resonance imaging (MRI) lesions involving more than two sites or lesions involving the infratentorial, and stress hyperglycemia, odds ratio(OR) were 13.468, 4.580, 2.378, 10.196, 3.012, and 6.316 respectively. Conclusion SVE is a serious threat to quality of children's life, convulsive status, respiratory failure, longer fever period, severely abnormal EEG, head MRI lesions involving more than two sites or lesions involving the infratentorial, and stress hyperglycemia are risk factors for prognosis of SVE in children.
ABSTRACT
Objective To observe the effect of continuous blood purification ( CBP ) in treatment of patients with severe viral encephalitis (SVE) combined with status epilepticus (SE).Methods Twenty-four SVE patients combined with SE were collected.Of which 15 cases received conventional treatment was control group, while 9 cases received CBP on the basis of conventional therapy was treatment group.The two groups were observed for curative effects.Results Compared with the control group, the remission time of fever, consciousness recovery, status epilepticus and mechanical ventilation were significantly shortened in treatment group ( all P<0.05 ) .The curative effects between the two groups were no significantly different.Conclusion For SVE patients with SE, the CBP treatment combined with conventional treatment can quickly relieve symptoms and improve the prognosis.
ABSTRACT
Objective To observe the therapeutic effect of reformed subhibernation therapy on status epilepticus in patients with severe viral encephalitis.Methods 96 children with severe viral encephalitis complicated by status epilepticus were randomly divied into control group and experimental group.Control group: routine treatment was given that includes anticonvulsivus,ice compress and conventional therapy.The anticonvulsivus was applied in five drugs: the same doses of wintermin and phenergan mixed up,10% chlorpromazine hydrochloride,luminal,valii,the drugs were delivered when convulsion occurred otherwise not.Experimental group: in addition to routine treatment reformed subhibernation therapy was given.The anticonvulsivus drug's was delivered in return each 4-6 h according to the drugs half life.And anticonvulsivus drugs were applied for 2 d then gotten off.The clinical manifestation,auxiliary examination and therapeutic efficacy of patients in two groups were observed.Results All of 96 cases were analyzed.The lotal effective rate in experimental group is higher than that in control group(?2=5.872,P