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目的观察用亚冬眠疗法联合克脑迷(氨乙基异硫脲)治疗重症病毒性脑炎的近、远期疗效,探讨重症病毒性脑炎减少后遗症的理想治疗方案。方法1990年4月至2006年5月,对武汉市第九医院儿科住院的27例重症病毒性脑炎患儿,采用开放平行对照分析方法,随机分成两组,A组13例为对照组,采用常规抗惊厥、退热治疗;B组14例为药物组,在常规抗惊厥、退热治疗6h无效后,采用亚冬眠疗法联合克脑迷方案治疗;观察比较A、B两组患儿在入院后0~2个月的临床主要症状平均分值及差异,判断其近期疗效;在入院后12个月末期观察比较A、B两组患儿后遗症病例所占的百分率及差异,判断其远期疗效。结果发现近期疗效中B组比A组患儿抽搐、发热、呕吐分值下降非常显著(P<0.01),头痛分值下降显著(P<0.05),死亡分值下降、意识障碍及呼吸循环分值上升,但差异均无统计学意义(P>0.05)。发现远期疗效中B组比A组后遗症病例所占的百分率下降,差异有统计学意义(P<0.01)。结论亚冬眠疗法联合克脑迷治疗重症病毒性脑炎既能迅速而有效地缓解患儿抽搐、发热、呕吐、头疼症状,又没有显著加重患儿的意识障碍和呼吸抑制,是重症病毒性脑炎减少后遗症的有效治疗方案。
Objective To observe the short-term and long-term curative effects of sub-hibernation therapy combined with gavage (aminoethyl isothiourea) in the treatment of severe viral encephalitis and to explore the ideal treatment plan for the reduction of sequelae of severe viral encephalitis. Methods From April 1990 to May 2006, 27 children with severe viral encephalitis who were hospitalized in pediatric department of the Ninth Hospital of Wuhan City were randomly divided into two groups according to the open parallel control analysis. Group A (13 cases) In group B, 14 patients were treated with anticonvulsant and antipyretic therapy for 6h, and then treated with sub-hibernation therapy combined with gopyrizone. The patients in group A and B were compared 0 to 2 months after admission, the average score of major clinical symptoms and differences to determine the short-term effect; at the end of 12 months after admission to observe the A and B groups of children with sequelae of the percentage and the difference between the judge, far Period of efficacy. The results showed that in the short-term treatment, the scores of convulsions, fever and vomiting in group B were significantly lower than those in group A (P <0.01), the scores of headache decreased significantly (P <0.05), the scores of death decreased, the disturbance of consciousness and respiratory circulation Value increased, but the difference was not statistically significant (P> 0.05). Found that the long-term efficacy of the B group than the sequelae of the percentage of cases decreased, the difference was statistically significant (P <0.01). Conclusion Asiatic sleep therapy combined with gavage treatment of severe viral encephalitis can not only promptly and effectively relieve the symptoms of convulsions, fever, vomiting and headache in children but also have no significant aggravating disturbance of consciousness and respiratory depression in children with severe viral encephalitis Inflammation to reduce sequelae of an effective treatment program.