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目的探讨肠道感染相关性脑病的临床特点。方法分析15例与文献报道的肠道感染相关性脑病相一致的患儿特点。结果均为突发高热、惊厥、水样腹泻、代谢性酸中毒、肝酶显著升高,前躯期为严重水样便、发热。大便检测6例轮状病毒阳性,脑功能障碍和肝功能损害为主要表现是本病的临床特点;肝酶学极显著改变,血胆红素多正常。入院1~2 d后肝转氨酶达高峰,多于1周内恢复正常,病情缓解。本组无一例死亡,2例遗留神经系统后遗症。结论应提高对肠道感染相关性脑病的临床认识。治疗关键是纠正脱水、酸中毒,肠源性的全身炎症反应可能参与发病机制。
Objective To investigate the clinical features of intestinal encephalopathy associated with intestinal infection. Methods Fifteen cases of children with intestinal infectious encephalopathy were reported in the literature. The results were sudden high fever, convulsions, watery diarrhea, metabolic acidosis, liver enzymes increased significantly, the antecedent of severe watery stool, fever. Stool detection 6 rotavirus positive, brain dysfunction and liver dysfunction as the main manifestation of the clinical features of this disease; liver enzymology significantly changed, more than normal serum bilirubin. Admitted to hospital 1 ~ 2 d after the peak of liver aminotransferase, more than 1 week returned to normal, the disease eased. No one died in this group, 2 cases left over from the nervous system sequelae. Conclusion The clinical knowledge of encephalopathy associated with intestinal infection should be improved. Treatment is the key to correct dehydration, acidosis, intestinal systemic inflammatory response may be involved in the pathogenesis.