50例森林脑炎患者治疗体会

目的通过对我院自2007至2010年收治的50例森林脑炎患者的临床资料回顾性分析,探讨该病的主要死亡原因。方法收治的50例患者中男性41例,女性9例,年龄17～60岁。平均年龄32.5岁,所有患者均生活在疫区,至少1次蜱叮咬史。潜伏期后出现典型临床表现,结合森林脑炎免疫荧光抗体阳性,及相关的辅助检查结果,除外其他中枢神经系统感染性疾病后诊断。结果本组50例患者,治愈38例,死亡7例,放弃治疗3例,遗留肢体运动障碍、智能减退、精神症状等后遗症者2例。结论森林脑炎病毒侵犯脑组织及脑干后引起的呼吸肌麻痹,呼吸机辅助呼吸可大大减少患者的病死率,以及积极地给予抗病毒、输注丙种球蛋白、防治脑水肿、预防肺内感染、维持水电解质平衡亦非常重要。提前接种森林脑炎疫苗,对于进入林区人员大有裨益。

50 Cases of Clinical Treatment of Patients with Tick-borne Encephalitis

Objective In our hospital from 2007 to 2010,50 cases of tick-borne encephalitis patient clinical data retrospectively,discuss the disease is the leading cause of death.Method 50 cases of male patients in 41 cases,feimale 9cases,aged 17 to 60 years old.The average age of 32.5 years,all patients living in endemic areas.At least 1 tick bites.After the incubation period of typical clinical manifestations,combined with forest encephalitis immunofluorescence antibody positive,and related auxiliary examination results,with the exception of other central nervous system infectious disease after diagnosis.Results 50 patients,38 cases were cured,7 cases died,giving up treatment in 3 cases,left limb movement disorder,intelligence impairment,psychiatric symptoms and sequelae in 2 cases.Conclusion Forest encephalitis virus invasion of brain and brainstem after induced respiratory muscle paralysis,assisted mechanical ventilator patients can greatly reduce the mortality,and actively given antiviral,gamma globulin,prevention and treatment of cerebral edema,prevention of lung infection,maintaining water and electrolyte balance is also very important.Advance of forest encephalitis vaccine inoculation into the forest,be of great advantage for personnel