儿童急性脑炎/脑病的不良预后因素分析

目的 探究影响急性脑炎/脑病(acute encephalitis/encephalopathy, AE)患儿预后的因素。方法 回顾性分析2018年6月1日至2021年5月30日于福建省妇幼保健院儿科临床确诊为AE患儿的临床资料及不良预后(出院时有以下情况：院内死亡、气管切开、胃肠内管饲、需要康复治疗及难治性癫痫)。采用多因素Logistic回归分析影响AE不良预后的因素。结果 研究纳入AE患儿105例，出现不良结局34例(32.4%),其中发生院内死亡5例(4.8%)。多因素Logistic回归分析结果显示，发热持续时间长(>5天)、惊厥发作≥3次、呼吸衰竭、合并脏器功能损伤是AE不良预后的危险因素。结论 发热持续时间长(>5天)、惊厥发作≥3次、呼吸衰竭、合并脏器功能损伤与AE不良预后密切相关，临床早期发现高风险患儿并及时给予针对性干预措施可改善患儿预后。

Exploring factors influencing adverse prognosis in children with acute encephalitis/ encephalopathy

Objective To explore the prognostic factors in children with acute encephalitis/encephalopathy (AE). Methods Retrospective analysis was made on the clinical data and adverse prognosis of children clinically diagnosed as AE in the pediatrics department of Fujian Maternal and Child Health Hospital from June 1, 2018 to May 30, 2021. The following conditions were found at the time of discharge: hospital death, tracheotomy, gastroenteric tube feeding, rehabilitation treatment, and intractable epilepsy. Multivariate Logistic regression was used to analyze the factors influencing the adverse prognosis of AE.Results Among 105 children with AE included in the study, 34 (32.4%) had adverse outcomes, including 5 (4.8%) hospital deaths. Multivariate Logistic regression analysis showed that long duration of fever (>5 days), ≥ 3 seizures, respiratory failure, and combined organ dysfunction were the risk factors for adverse prognosis of AE. Conclusion Long duration of fever (>5 days), ≥ 3 seizures, respiratory failure, and organ dysfunction are closely related to the poor prognosis of AE. Early detection of high-risk children and timely intervention can improve the prognosis of children with AE.