论文部分内容阅读
目的 总结急性重症疱疹病毒性脑炎(HVE)的临床表现和治疗,以进一步提高其诊断和治愈率。方法 收集近6年来重症HVE 75例,并对其临床表现,EEG,CSF,头颅 CT和 MRI检查以及治疗结果进行分析。结果 全部病例均有发热,意识障碍62例,精神异常42例,癫痫 53 例,偏瘫 12 例。EEG异常率 100%,多以中重度异常明显。CSF检查68例均压力增高,蛋白和白细胞增高;头颅 CT和 MRI检查绝大多数提示额颞部损害明显。经治疗后,痊愈47例(65 3%),好转和轻度后遗症 14 例,重度后遗症 5 例,死亡 9 例(12%)。结论 重症HVE病情危重,CSF、头颅CT和MRI以及EEG均出现高异常率,提示与病情严重程度呈平行关系,在诊断和预后判断方面均具有重要意义,尤以EEG意义更大。在综合治疗的基础上,无环鸟苷加干扰素治疗可以大大改善预后。
Objective To summarize the clinical manifestation and treatment of acute herpes simplex virus encephalitis (HVE) to further improve its diagnosis and cure rate. Methods 75 cases of severe HVE in recent 6 years were collected and their clinical manifestations, EEG, CSF, CT and MRI examination and treatment results were analyzed. Results All patients had fever, disturbance of consciousness in 62 cases, mental abnormalities in 42 cases, epilepsy in 53 cases and hemiplegia in 12 cases. EEG abnormality rate of 100%, mostly in moderate to severe abnormalities significantly. CSF pressure in 68 cases were increased, increased protein and white blood cells; the vast majority of head CT and MRI examination showed significant damage to the frontotemporal. After treatment, 47 cases (65.3%) were cured, 14 cases had improvement and mild sequelae, 5 cases had severe sequelae and 9 cases died (12%). Conclusions Severe HVE is in critical condition. CSF, cranial CT, MRI and EEG all show high abnormal rate. The correlation between the severity and severity of HVE shows a parallel relationship, which is of great significance both in diagnosis and prognosis, especially in EEG. On the basis of comprehensive treatment, acyclovir plus interferon treatment can greatly improve the prognosis.