Liu Xiao-Jun, Li Wei, Zhang Yu-Qin, Liu Ya-Min, Liu Li-Zhen
Department of Neurology, Tianjin Children's Hospital, Tianjin 300074, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2009 Dec;11(12):967-9.
To study the clinical features and treatment of serious brainstem encephalitis caused by enterovirus 71 (EV71) infection.
The clinical data of 32 hospitalized children with serious brainstem encephalitis caused by EV71 infection between May and December 2008 were retrospectively reviewed.
The children whose age was younger than 3 years old accounted for 88% (22 cases). Fever(>38.5 degrees centigrade)lasting at least 3 days, frequent vomiting and limb twitch were presented as the main manifestations in the 32 children. Cyanosis, tachypnea, tachycardia and cold extremities were observed, and pulmonary edema or even pulmonary hemorrhage occurred in 8 children 3 to 4 days after the onset. The 32 children received a medical treatment: reduction of intracranial pressure with mannitol or frusemide, inhibition of inflammation reactivity with gamma globulin and methylprednisolone, and improvement of cardiac function and pulmonary edema with innotropic agents, fluid restriction and positive mechanical ventilation.
Vegetative nerve functional disturbance is the main clinical feature of brainstem encephalitis caused by EV71 infection in children. An early identification and treatment of pulmonary edema or hemorrhage is of great importance.
研究肠道病毒71型（EV71）感染所致重症脑干脑炎的临床特点及治疗方法。
回顾性分析2008年5月至12月间收治的32例EV71感染所致重症脑干脑炎患儿的临床资料。
3岁以下患儿占88%（22例）。32例患儿主要表现为发热（体温>38.5℃）持续至少3天、频繁呕吐及肢体抽搐。出现发绀、呼吸急促、心率加快及四肢冰凉，8例患儿在发病3至4天后出现肺水肿甚至肺出血。32例患儿接受了如下治疗：用甘露醇或呋塞米降低颅内压，用丙种球蛋白和甲泼尼龙抑制炎症反应，用强心剂、限制液体入量及机械通气改善心功能和肺水肿。
植物神经功能障碍是儿童EV71感染所致脑干脑炎的主要临床特点。早期识别和治疗肺水肿或出血至关重要。
