病毒性脑炎急性期伴发癫痫患者临床资料分析

发布时间：2018-05-29 08:30

本文选题：病毒性脑炎 + 癫痫　；参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的通过回顾性分析116例病毒性脑炎患者临床资料,比较伴发癫痫组及非癫痫组患者临床资料差异,总结伴发癫痫组患者特点,为及时预测和发现病毒性脑炎患者伴发癫痫、采取积极有效的治疗提供依据。方法收集2011年1月至2016年12月近6年时间内就诊于宁夏医科大学总院及心脑血管病医院的病毒性脑炎患者(116例),根据急性期(1月内)有无癫痫发作分为伴发癫痫组(39例)及非癫痫组(77例),通过查阅医院电子病历系统,收集所有患者的一般情况、病史、查体、临床表现特别是癫痫发作情况、实验室检查、脑脊液检查、影像学检查、脑电图检查、治疗、出院情况等资料,使用SPSS17.0分析、统计伴发癫痫组和非癫痫组患者上述各指标。结果两组患者病史比较:两组患者入院情况、认知功能障碍、意识障碍差异有统计学意义(P0.05),其他临床表现差异无统计学意义。两组患者辅助检查比较:伴发癫痫组患者血白细胞总数、中性粒细胞及单核细胞数偏高(P0.05),血钾水平较低(P0.05);伴发癫痫组脑脊液葡萄糖含量偏高(P0.05);伴发癫痫组颅脑影像学检查异常率较高(P0.05),脑电图中重度异常者所占比高(P0.05);余辅助检查差异无统计学意义。两组患者治疗及预后:所有患者均给予抗病毒治疗,39例癫痫发作者有28例(71.79%)使用抗癫痫药物。伴发癫痫组患者预后较非癫痫组预后差(P0.05)。结论1.病毒性脑炎急性期伴发癫痫患者临床常见,占33.62%,发作形式主要以全面性发作为主,占64.10%,任何年龄均可发病。2.病毒性脑炎伴发癫痫患者较非癫痫患者颅脑影像学检查异常率更高、脑电图异常程度更重。3.癫痫发作加重病毒性脑炎患者意识障碍和认知功能障碍,病毒性脑炎伴发癫痫患者较非癫痫患者预后差。
[Abstract]:Objective to retrospectively analyze the clinical data of 116 patients with viral encephalitis, compare the clinical data between the patients with epilepsy and those without epilepsy, and summarize the characteristics of patients with epilepsy in order to predict and discover the patients with viral encephalitis. To provide evidence for active and effective treatment. Methods 116 patients with viral encephalitis were collected from January 2011 to December 2016 in Ningxia Medical University General Hospital and Cardiovascular and Cerebrovascular Disease Hospital. Group (n = 39) and non-epileptic group (n = 77). To collect general information, medical history, body examination, clinical manifestations, especially seizures, laboratory examination, cerebrospinal fluid examination, imaging examination, electroencephalogram examination, treatment and discharge status of all patients, and to use SPSS17.0 analysis. The above indexes of patients with epilepsy and non-epilepsy were statistically analyzed. Results there were significant differences in admission status, cognitive dysfunction and consciousness disorder between the two groups (P 0.05), but there was no significant difference in other clinical manifestations between the two groups. Comparison between the two groups: the total number of white blood cells in patients with epilepsy, The number of neutrophils and monocytes was high (P0.05), the level of serum potassium was lower (P0.05N), the cerebrospinal fluid (CSF) glucose content was higher (P0.05), the abnormal rate of craniocerebral imaging examination was higher (P0.05), and the proportion of patients with severe abnormal EEG was high (P0.05). There was no significant difference in auxiliary examination. Treatment and prognosis: all patients were treated with antiviral therapy. 28 of 39 epileptic seizures were treated with antiepileptic drugs. The prognosis of patients with epilepsy was worse than that of non-epileptic patients (P 0.05). Conclusion 1. Viral encephalitis accompanied with epilepsy is common in clinic, accounting for 33.62%. The main form of attack is comprehensive attack, 64.10%, any age can attack. 2. The abnormal rate of craniocerebral imaging examination in patients with viral encephalitis associated with epilepsy was higher than that in non-epileptic patients, and the degree of abnormal EEG was higher than that in non-epileptic patients. The patients with viral encephalitis had worse prognosis than non-epileptic patients.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R512.3;R742.1

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