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目的研究手足口病并发脑炎患儿的临床表现、脑电图特征,评估脑电图对手足口病合并脑炎患儿的早期评价及预后判断的价值。方法 2013年至2014年入住我院感染科病房并接受治疗的手足口病并发脑炎患儿的临床资料,系统整理后进行回顾性分析。共选取205例,均由市级手足口病专家组确诊,均为血EV71-Ig M(+)。年龄5月~14岁,平均2.15岁,其中男143例,女62例,男女之比为2.31:1。对照组:200例,为我院同期门诊的及其他科室住院的非HFMD的普通病毒性脑炎的患儿。结果 205例患儿进行常规脑电图检查,其中195例出现清醒状态下脑电图异常,总异常率为95.12%。对照组异常189例,异常率为94.50%,总异常率差异无统计学意义(P>0.5);但两组重度异常分别为10例(异常率4.88%)及2例(异常率1.0%),重度异常率差异有统计学意义(P<0.05)。HFMD组和对照组患儿皮疹、发热、精神萎靡、肢体抖动的发生率间差异有统计学意义(P<0.01)。结论 EV-71感染手足口病脑炎患儿脑电图异常率高,重症手足口病脑炎较普通病毒性脑炎更急、更重。脑电图对手足口病并发脑炎的临床诊断及预后估计有较高的参考价值。
Objective To study the clinical manifestations, EEG features of children with hand-foot-mouth disease complicated with encephalitis and to evaluate the value of EEG in the early evaluation and prognosis of children with hand-foot-mouth disease complicated with encephalitis. Methods The clinical data of children with hand-foot-mouth disease complicated with encephalitis who were admitted to the infection ward of our hospital from 2013 to 2014 were systematically analyzed and retrospectively analyzed. A total of 205 cases were selected, all of which were diagnosed by municipal expert group of hand, foot and mouth disease, all of which were blood EV71-Ig M (+). Aged from May to 14 years old, average 2.15 years of age, including 143 males and 62 females, the ratio of male to female was 2.31: 1. Control group: 200 cases of children with non-HFMD common viral encephalitis hospitalized in our hospital over the same period and other departments. Results A total of 205 children underwent routine electroencephalogram (EEG) examination. Among them, 195 cases showed abnormal EEG abnormality with a total abnormal rate of 95.12%. In the control group, there were 189 abnormal cases with an abnormality rate of 94.50%. There was no significant difference between the two groups (P> 0.5), but severe abnormalities were found in 10 cases (abnormal rate 4.88%) and 2 cases (abnormal rate 1.0%), respectively , The rate of severe abnormalities was significantly different (P <0.05). The incidences of rash, fever, apathetic and limb jitter in HFMD group and control group were significantly different (P <0.01). Conclusion The abnormal rate of EEG in children with EV-71 infection is high and severe encephalitis in hand, foot and mouth disease is more urgent and heavier than normal viral encephalitis. EEG has the higher reference value for the clinical diagnosis and prognosis of hand-foot-mouth disease complicated by encephalitis.