小儿腹泻并脓毒症相关性脑病的临床诊断及治疗

摘要

Objective To investigate the clinical characteristics, diagnosis, treatment and outcome of diarrhea with sepsis associated encephalopathy ( SAE) in children.Methods A retrospective analysis was made on the data of 40 children suffered from diarrhea with SAE.Results The main symptoms including fever, diarrhea, altered mental status and seizures. Cerebrospinal fluid analysis showed an elevation of protein concentration in 10 cases.The electroencephalogram ( EEG) showed:20 cases with delta waves, 5 cases with suppression waves.After the comprehensive rescue treatment, 20 cases recovered completely, and 15 cases survivors had neurological deficits, 5 cases died.Conclusions EEG is the most sensitive test for SAE.The main treatment of SAE focused on control of sepsis.Early diagnosing and therapy of SAE in children can raise survival rate and reduce death rate.%目的 探讨小儿腹泻并脓毒症相关性脑病( SAE)的临床特征、诊断要点和治疗转归. 方法对某医院经治的40例腹泻并SAE患儿临床资料进行回顾性分析. 结果 本组患儿主要症状有发热、腹泻,意识状态改变及抽搐. 脑脊液内蛋白升高10例. 脑电图示δ波20例,抑制波形5例. 本组患儿均给予综合抢救治疗. 完全恢复正常20例,有神经系统后遗症15例,死亡5例. 结论 目前脑电图( EEG)是最敏感的辅助检查方法. 治疗主要针对脓毒血症. 早期诊断和治疗SAE,可显著提高存活率,降低病死率.