儿童脑型疟128例的诊断和治疗

目的了解儿童脑型疟临床特征和降低其病死率。方法对1996～1997年住院128例儿童脑型疟的临床特征、诊断治疗、病死原因进行分析。结果1～5a儿童发生率66％，痊愈113例，后遗症4例，死亡11例，死亡率8．6％。临床特征有发热、咳嗽、吐泻、惊厥、意识障碍等。血片见疟原虫可确诊，首次阴性应反复多次检查。惊厥、意识障碍者应排除其他疾患。结论及时正确诊断，尽早抗疟治疗，对抗药性及有并发症等治疗是降低儿童脑型疟病死率的关键。

Diagnosis and treatment of cerebral malaria in children

Objective To study the clinical featuress and to reduce the mortality of cerebral malaria in children. Method The authors analyzed the clinical features,diagnosis,treatment and causes of death in 128 children aged 8 months to 13 years seen from 1996 to 1997. Results Cerebral malaria occurred between one and five years of age;of 128 children,13 cases were cured,4 cases exhibitied sequelae 11 cases(8.6%)were dead.The main clinical manifestations were usually fever,cough,vomiting,diarrhea,convulsions and coma.The presence of malaria parasites in blood film mode out the diagnosis of malaria.Frequent tests should be done if no parasites were found in the blood film at first.The exclusion of other causes of convulsions and coma was essental for patients with convulsions and coma. Conclusions Promnt diagnosis and treatment with antimalaria drugs of the cases with cloroquine resistence and complications are critical factors to decrease mortality of cerebral malaria in children.