王维 李佳 王立利

[摘要] 目的 探究动态脑电图（AEEG）联合磁共振成像（MRI）在儿童病毒性脑炎的早期诊断和预后的价值。 方法 回顾分析2015年5月～2017年5月于河北省唐山市妇幼保健院收治的54例病毒性脑炎患儿的临床资料以及AEEG、MRI影像学资料，观察AEEG联合MRI诊断准确率以及单一MRI诊断准确率，并分析AEEG、MRI各自诊断结果。 结果 在54例病毒性脑炎患儿中，AEEG联合MRI诊断准确率为96.30%，显著高于MRI单一诊断准确率81.48%，差异有统计学意义（P < 0.05）;经AEEG检查显示，54例患儿中重度异常12例，中度异常17例，轻度异常20例，异常率为90.74%;54例患儿中，8例MRI脑实质未见明显异常信号，2例误诊，44例经MRI检查可见病灶，异常率为81.48%。 结论 AEEG联合MRI在早期诊断儿童病毒性脑炎具有较大的应用价值，可为医师提供可靠的诊断依据，及早发现并治疗，对临床诊断具有一定借鉴意义。

[关键词] 动态脑电图;磁共振成像;儿童;病毒性脑炎;诊断价值

[中图分类号] R725          [文献标识码] A          [文章编号] 1673-7210（2019）03（a）-0124-04

[Abstract] Objective To explore the value of ambulatory electroencephalography （AEEG） combined with magnetic resonance imaging （MRI） in the early diagnosis and prognosis of viral encephalitis in children. Methods Retrospective analysis was conducted on the clinical data， AEEG and MRI imaging data of 54 cases of viral encephalitis admitted to Tangshan Maternal and Child Health Hospital in Hebei Province from May 2015 to May 2017. The diagnostic accuracy of AEEG combined MRI and single MRI were observed， and the respective diagnostic results of AEEG and MRI were analyzed. Results In 54 childrens with viral encephalitis， the diagnostic accuracy of AEEG combined with MRI was 96.30%， which was significantly higher than 81.48% of the MRI single diagnostic accuracy rate， and the difference was statistically significant （P < 0.05）; AEEG examination showed that 12 cases were severe abnormality in 54 cases of childrens， 17 cases were moderate abnormality， 20 cases were mild abnormality， and the abnormal rate was 90.74%; in the 54 cases， 8 cases had no abnormal signal in MRI brain parenchyma， 2 cases were misdiagnosed， and 44 cases showed lesions by MRI examination， the abnormal rate was 81.48%. Conclusion AEEG combined with MRI has great value in early diagnosis of viral encephalitis in childrens. It can provide reliable diagnostic basis for doctors， early detection and treatment， so it has certain reference significance for clinical diagnosis.

[Key words] Ambulatory electroencephalography; Magnetic resonance imaging; Children; Viral encephalitis; Diagnostic value

病毒性腦炎是一种中枢神经系统感染性疾病，是因多种病毒致使颅内急性感染，由于儿童自身免疫力不完善，成为该病的主要发病群体，同时具有病原多样性、散发性特点，近年来发病率呈不断增长趋势，多致患儿头痛、昏迷、嗜睡，病情严重时可遗留后遗症，或致使死亡，对患儿身心健康造成严重影响[1-2]。大部分患儿的临床症状不典型，诊断较为困难，当前主要利用病毒学以及免疫学进行检查确诊，但基层医院应用率较低，同时还可利用动态脑电图（ambulatory electroencephalography，AEEG）、磁共振成像（magnetic resonance imaging，MRI）等辅助检查对本病进行早期诊断以及治疗，但AEEG与MRI又存在差异性，AEEG主要对脑功能变化情况进行反映，MRI则主要对脑形态改变进行反映[3]。本研究对病毒性脑炎患儿进行AEEG与MRI联合诊断，以探讨其诊断价值，并进行有效的早期诊断以及时治疗，避免严重后遗症发生，现报道如下：

1 资料与方法

1.1 一般资料

选取2015年……