轻度胃肠炎并良性婴幼儿惊厥的临床分析

发布时间：2018-11-20 18:45

【摘要】：目的探讨轻度胃肠炎并良性婴幼儿惊厥的病因、临床特点及预后,提高对该病的评估、干预及健康管理的水平。方法回顾性分析2013年10月-2014年9月广州市妇女儿童医疗中心儿科急诊40例轻度胃肠炎并良性婴幼儿惊厥患儿的临床资料及随访情况。结果 67.5%病例为12~23个月龄的儿童,以冬春季多见,47.5%患儿于病程第2天发生惊厥,绝大部分(97.5%)为全面发作,接近一半病例(47.5%)仅发作1次,发作持续时间为1~5 min。所有患者均无阳性家族史,其中2例既往有热性惊厥史。在所有患者中,轮状病毒阳性18例(45.0%)。全部患者脑脊液常规和生化均正常,其中2例脑电图和头颅磁共振同时异常。全部患者随访18个月,其中2例于1年内出现热性惊厥,1例出现反复无热惊厥,最后确诊为癫痫,需服用抗癫痫药物。结论轻度胃肠炎并良性婴幼儿惊厥常见于1~2岁儿童,多发生在冬春季胃肠炎的早期,轮状病毒感染可增加其发生的风险。大部分预后良好,少数患儿有发展为癫痫的可能,对于惊厥发作次数多、持续时间长和(或)脑电图、影像学检查异常者,需加强随访。
[Abstract]:Objective to investigate the etiology, clinical characteristics and prognosis of mild gastroenteritis with benign convulsion, and to improve the evaluation, intervention and health management of the disease. Methods the clinical data and follow-up data of 40 children with mild gastroenteritis and benign infantile convulsion in pediatric emergency department of Guangzhou Women and Children Medical Center from October 2013 to September 2014 were analyzed retrospectively. Results 67.5% of the cases were children aged 12 to 23 months, most of them were in winter and spring, 47.5% of them had convulsions on the second day of the disease course, most of them (97.5%) had full-scale seizures, and nearly half of the cases (47.5%) had only one attack. Duration of attack was 1: 5 min. All the patients had no positive family history, 2 of them had a history of febrile convulsion. Of all the patients, 18 (45.0%) were rotavirus positive. All patients had normal cerebrospinal fluid routine and biochemistry, 2 of them had abnormal EEG and cranial magnetic resonance simultaneously. All patients were followed-up for 18 months, 2 of them had febrile convulsion within one year, and 1 had recurrent non-febrile convulsion. Finally, epilepsy was diagnosed and antiepileptic drugs should be taken. Conclusion mild gastroenteritis with benign infantile convulsion is common in 1 or 2 year old children, and most of them occur in the early stage of gastroenteritis in winter and spring. Rotavirus infection may increase the risk of gastroenteritis. Most of the patients had good prognosis and a few children had the possibility of developing into epilepsy. For those with more seizures, longer duration and / or abnormal EEG and imaging examination, the follow-up should be strengthened.
【作者单位】：广东省广州市妇女儿童医疗中心;
【分类号】：R725.7

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