流行性乙型脑炎112例临床分析

目的分析流行性乙型脑炎(乙脑)的临床表现与临床流行病学规律,明确该病有效预防措施。方法2003年5月至2007年12月治的112例乙脑的临床资料,观察其临床流行病学特点及临床特征。结果本组112例患者均为儿童,男63例,女49例,年龄4岁～12岁,平均年龄为4.65±0.75岁,其中89(79.46%)例为爆发流行病例,23(20.53%)例为散发流行病例,103(91.96%)例没有乙脑疫苗接种史。以急性起病,高热,头痛、多数患者有意识障碍(96例,85.71%)及癫痫发作(61例,54.46%),发病第二周血清或脑脊液乙脑IgM阳性。本组患者81(72.32%)例临床治愈,18(16.07%)例住院期间死亡。结论本病的临床特征主要为儿童罹患,发热、头痛为常见的临床表现,发病第二周血清或脑脊液乙脑IgM阳性,重症患者死亡率高,而夏秋季发病为其主要临床流行病学特点。乙脑疫苗注射仍是目前主要行之有效的预防措施。

Clinical Features in 112 Hospitalized Patients with Epidemic Japanese Encephalitis

Objective To investigate the clinical characters and epidemiological features of epidemic Japa- nese encephalitis for its efficient prevention. Methods The clinical character and epidemiological features of pa- tients with epidemic Japanese encephalitis admitted to Guangxi Gulping city People Hospital from May 2003 to De- cember 2007 were analyzed retrospectively. Results There were 112 cases, 63 boys and 39 girls, age ranging from 4 to 12years, with mean age 4.65 ＋ 0.75years. Of all the patients, 89 cases （79.46%） were fulminating epidemic and 23cases （20.53%） were emanating epidemic. All patients were from epidemiological regions and most of them （103cases, 91.96% ） without any history of inoculated epidemic Japanese encephalitis vaccine. All patients were with acute febrile, headache and 96 cases （85.71%） with unconscious, 61cases （54, 46% ） with epilepsy. Patients underwent an essay of ELISA for Japanese encephalitis virus immunoglobulin M in cerebrospinal fluid or serum on hospital admission. More patients were with ~,~tlv~ results for the essay in the second weeks after onset. Most pa- tients （81 cases, 72.32% ） reached a good outcome. In-hospital mortality was 16.07%. Conclusion From this da- ta, epidemic Japanese encephalitis is characterized by children involved, main manefestin with acute febrile and headache, and a high mortality for thoes with severe symptom. And it often outbreaks in summer and autumn. Cunr- rently, vacination is the most efficeut metheds for the prevention of epidemic Japanese encephalitis.