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急性小脑共济失调患儿临床特征及住院时间影响 因素分析
赵佳怡
()
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目的 分析急性小脑共济失调(ACA)患儿临床资料,探讨影响患儿住院时间的相关因素。 方法 回顾性纳入 2017 年 7 月至 2019 年 12 月于哈尔滨医科大学附属第一医院就诊住院完成治疗的 ACA 患儿 48 例,收集患者病案资料并随访,内容包括一般情况、既往史、病因、临床症状、辅助检查、治 疗方案、后遗症状等,并采用单因素和多因素分析影响患儿住院时间的因素。结果 48 例患儿中,感染 后 ACA 35 例(72.9%),最常见为呼吸道感染,感染距发病时间为 4~20 d,平均(9.0±3.0)d。患儿既往肠 道手术病史 22 例(45.8%)。全部应用糖皮质激素治疗,随访 2~6 个月,48 例患者均完全恢复正常。患 儿年龄(t=-4.359,P<0.001)、既往手术史(t=-2.173,P<0.05)、入院前症状持续时间(t=-4.469,P<0.001)、 入院时伴有发热及其他感染(t=-3.363,P< 0.05)、伴有严重的临床症状(t=-4.415,P< 0.001)、脑脊液 改变(t=-3.853,P< 0.001)、影像学改变(t=-6.609,P< 0.001)、脑电图改变(t=-5.139,P< 0.001)及应用 免疫球蛋白治疗(t=-9.777,P< 0.001)对住院时间存在影响,差异具有统计学意义;其中入院前症状 持续时间(95%CI=0.009~2.554,t=2.039,P< 0.05)、应用免疫球蛋白治疗(95%CI:2.582~5.971,t=5.109, P< 0.001)为住院时间的独立影响因素。结论 入院前症状持续时间、应用免疫球蛋白治疗为儿童 ACA 住院时间的影响因素。
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Analysis of clinical characteristics and influencing factors of hospitalization time in children with acute cerebellar ataxia
Zhao Jiayi
()
Abstract:
Objective To analyze the clinical data and explore the related factors affecting the hospitalization time of children with acute cerebellar ataxia (ACA). Methods A total of 48 children with ACA who were hospitalized in the First Affiliated Hospital of Harbin Medical University from July 2017 to December 2019 were included retrospectively. Clinical data were collected and followed up, including general situation, past history, etiology, clinical symptoms, auxiliary examination, treatment plan, sequelae and so on. The factors affecting hospitalization time were analyzed by single factor and multi factor analysis methods. Results After infection, acute cerebellar ataxia was found in 35 (72.9%) of 48 children. The most common infection was respiratory tract infection. The infection time was 4-20 days, with an average of (9.0±3.0) days. There were 22 cases (45.8%) with previous intestinal operation history. All patients were treated with glucocorticoid and followed up for 2 to 6 months. All 48 patients recovered completely. Age (t=-4.359,P < 0.001), previous operation history (t=-2.173,P < 0.05), duration of symptoms before admission (t=-4.469,P < 0.001), fever and other infections at admission (t=-3.363,P< 0.05), severe clinical symptoms (t=-4.415,P< 0.001), cerebrospinal fluid changes (t=-3.853,P < 0.001), imaging changes (t=-6.609,P < 0.001), EEG changes (t=-5.139, P < 0.001) and immunoglobulin therapy (t=-9.777, P < 0.001) had significant effect on the time of hospitalization, with statistical significance. Among them, the duration of symptoms before admission (95%CI: 0.009-2.554, t=2.039,P < 0.05) and immunoglobulin treatment (95%CI: 2.582-5.971,t=5.109, P < 0.001) were independent factors. Conclusions The duration of symptoms before admission and the application of immunoglobulin were the influencing factors of the hospitalization time of children with acute cerebellar ataxia.

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