Clinical Features And Prognostic Analysis Of Severe Japanese B Encephalitis In Children

Objective:To explore the risk factors associated with the prognosis of severe Japanese encephalitis,to provide evidence for clinical treatment and prognostic evaluation.Methods : The clinical data of 73 cases in Children Hospital of Chongqing medical university since January 2015 to December 2017 were retrospectively analyzed,The clinical features and prognostic factors were analyzed.Results:There were 50 patients in good prognosis group,23 patients in poor prognosis group.Medium high fever(100%),conscious disturbance(98.6%)and seizures(76.4%).Respiratory failure,hypokalemia,gastrointes tinal bleeding and hypoproteinemia were the major complication,and the m ortality rate is 11%,the common sequelae in survivors were cognitive impa irment,limb paralysis and secondary epilepsy.All the electroencephalogra m were abnormal,diffuse slow waves were common and some of them had epileptic discharge.The abnormal rate of cranial imaging was 98.6%,thala mus,midbrain and basal ganglia were the main lesions.Statistical analysis r evealed that frequent convulsions,respiratory failure,atelectasis,liver funct ion impairment,hypokalemia,hypoproteinemia,sepsis,longer hospitalizati on,deep coma,dysphagia,use of ventilator may be associated with poor pr ognosis,frequent convulsions is independent risk factor for poor prognosis in children.Conclusion:1.The children were susceptible population to JE,the mortality of severe Japanese encephalitis is high and survivors may have severe sequelae.2.Frequent convulsions,respiratory failure,atelectasis,liver function impairment,hypokalemia,hypoproteinemia,sepsis,length of hospital stay,deep coma and dysphagia occur in the course of disease may be associated with poor prognosis,frequent convulsions is independent risk factor for poor prognosis in children.