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1995年5-7月我院共收治242例病毒性脑炎,男 181例,女61例.年龄4个月-12岁,以6月份为发病高峰。临床表现:发热242例.呕吐155例,嗜睡107例,惊厥72例.头痛54例,昏迷31例,咳嗽29例,腹泻25例,腹痛13例,脑膜刺激征127例.皮疹4例.双下肢软瘫1例。并发呼吸衰竭26例.心力衰竭17例.心肌炎22例。查心电图159例。明显ST—T波改变和/或低电压22例。查血心肌酶49例,CPK·MB升高21例。血白细胞计数正常127例,>10X 10~[9]/L115例.7月份发病者查乙脑抗体14例阴性。查脑脊液156例.细胞计数10-50×10~[6]/L14例,-100×10~[6]/L9例,-150×10~[6]/L5例,蛋白、糖和氯化物均正常。脑脊液作肠道病毒分离15例,7例阳性;粪病毒分离20例.8例阳性,经鉴定均为柯萨奇B_2病毒。查脑电图131例,异常75例。经综合治疗及对症处理,重型患儿加用干扰索后,结果痊愈231例,好转1例,自动出院1例.死亡9例。死因为中枢性呼吸衰竭,5例同时合并心力衰竭。尸解2例为非化脓性脑膜脑炎、急性弥漫性心肌炎、肺淤血及急性心力衰竭。出院半年随访96例,发现2例轻度智力低下.1例两下肢不对称性软瘫。本次病毒性脑炎以重型病例较多,多有心肌损伤.死亡率高,脑脊液抽样检查.疑为柯萨奇B_2病毒引起。因此在夏秋季发病集中、表现有心脑损害,应想到柯萨奇病毒感?
From May to July 1995, a total of 242 cases of viral encephalitis were treated in our hospital, including 181 males and 61 females aged from 4 months to 12 years old, with a peak incidence in June. Clinical manifestations: fever in 242. Vomiting in 155 cases, 107 cases of lethargy, seizure in 72 cases. Headache in 54 cases, 31 cases of coma, 29 cases of cough, 25 cases of diarrhea, abdominal pain in 13 cases, 127 cases of meningeal irritation in 4 cases. 1 case of lower extremity palsy. 26 cases of respiratory failure, 17 cases of heart failure, 22 cases of myocarditis. Check ECG 159 cases. Significant ST-T wave changes and / or low voltage in 22 cases. 49 cases of blood enzymes, CPK · MB increased in 21 cases. Blood white blood cell count was normal in 127 cases,> 10X10 ~ [9] / L115 cases .In July, the incidence of JE antibody was negative in 14 cases. A total of 156 cases of cerebrospinal fluid (CSF) were studied, including 10 cases of 10-50 × 10 ~ 6 / L, -100 × 10 ~ 6 / L, and -150 × 10 ~ 6 / All normal. Cerebrospinal fluid for intestinal virus isolation in 15 cases, 7 were positive; feces virus isolated in 20 cases .8 were positive, identified as Coxsackie virus. Check EEG 131 cases, abnormal 75 cases. After comprehensive treatment and symptomatic treatment, heavy children with interfering cable, the results recovered 231 cases, 1 case of improvement, 1 case of spontaneous discharge, 9 cases of death. Death due to central respiratory failure, 5 cases of concurrent heart failure. 2 cases of autopsy for non-purulent meningoencephalitis, acute diffuse myocarditis, pulmonary congestion and acute heart failure. Ninety-six patients were discharged from hospital for six months, and 2 patients with mild mental retardation were found. The viral encephalitis to more severe cases, more myocardial damage. High mortality, cerebrospinal fluid sampling. Coxsackievirus B_2 suspected. Therefore, the incidence of concentrated in summer and autumn, the performance of heart and brain damage, should think of Coxsackie virus flu?